VICE  AND  HEALTH 


VICE  AND  HEALTH 

PROBLEMS— SOLUTIONS 


BY 
JOHN  CLARENCE  FUNK,  M.A.,  LL.B. 

DIBBCTOB,  BUBEAU  OF  PBOTECTIVB  SOCIAL  MEASURES,   PENNSYLVANIA 

STATE    HEALTH    DEPARTMENT;     SCIENTIFIC    ASSISTANT,    U.  S. 

PUBLIC    HEALTH    SEBVICE;    FOBMEBLY     U.  8.  NAVY  LAW 

ENFORCEMENT  BEPBESENTATIVE;   VICE-AGENT,    U.  S. 

DEPABTMENT    OP  JUSTICE;   SUPERVISING 

INSPECTOR,  U.  8.  OFFICE  OF  NAVAL. 

INTELLIGENCE 


J.  B.  LIPPINCOTT   COMPANY 
PHILADELPHIA  AND  LONDON 


fK 


COPYRIGHT,  1921,  sfr  j.  B.  LIPPINCOTT  COMPANY 


PRINTED  BY  J.  B.  LIPPINCOTT  COMPANY 

AT  THE  WASHINGTON  SQUARE   PRESS 

PHILADELPHIA,    U.   8.   A. 


TO 
THE  LEAGUE  OF  WOMEN  VOTERS 

WHOSE  INTEREST  AND  INSPIRATION 
WILL  DO  MUCH  FOR  GOOD  MORALS, 
GOOD  HEALTH  AND  GOOD  LIVING 

THIS  LITTLE  BOOK  IS  DEDICATED 

BY  THE  AUTHOR 


50584V 


PREFACE 

With  a  very  definite  development 
of  interest  among  groups  and  indi- 
viduals having  a  locality's  welfare 
sincerely  at  heart,  it  was  felt  that  a 
practical  guide  to  certain  phases  of 
one  of  the  most  important  municipal 
problems  would  be  of  some  assistance. 

Personal  experience,  covering  a 
number  of  years,  has  emphasized  the 
fact  that  many  people  who  become 
concerned  in  the  suppression  of  vice 
and  in  its  corollary,  the  reduction  in 
the  incidence  of  venereal  disease,  are 
quite  ignorant  of  many  of  the  neces- 
sary details  essential  to  a  successful 
attack.  Then,  too,  officials  are  some- 
times sincerely  wedded  to  certain 
ideas  of  control  and  tolerance  which 
have  been  cleverly  inspired  from  in- 
sincere motives. 

7 


8  PREFACE 

If,  therefore,  the  facts  herein  set 
forth  will  aid  in  a  rational  approach 
to  the  vice  and  venereal  questions,  this 
small  volume  will  have  served  its  pur- 
pose and  justified  its  existence. 

300  N.  Second  Street, 

Harrisburg,  Pa. 
Sept.  1, 1921.  J.C.F. 


CONTENTS 

CHAPTER  »AO« 

PREFACE  7 

I.    PROSTITUTION  AND  ITS  CAUSES 11 

II.    PROSTITUTION* AND  ITS  MANIFESTATIONS...  20 

III.  THE  BUSINESS  SIDE  OF  PROSTITUTION 33 

IV.  RESULTS  OF  PROSTITUTION 44 

V.    THE  GOVERNMENT'S  FIGHT 62 

VI.  MEDICAL  MEASURES 83 

VII.  LAW  ENFORCEMENT 98 

VIII.  MEDICO-LEGAL  MEASURES 120 

IX.  EDUCATION 137 

X.  WELFARE  AND  REHABILITATION 148 

XI.    GOOD  GOVERNMENT 161 


8  PREFACE 

If,  therefore,  the  facts  herein  set 
forth  will  aid  in  a  rational  approach 
to  the  vice  and  venereal  questions,  this 
small  volume  will  have  served  its  pur- 
pose and  justified  its  existence. 

300  N.  Second  Street, 

Harrisburg,  Pa. 
Sept.  1, 1921.  J.C.F. 


CONTENTS 


CHAPTER  »AOB 

PREFACE  7 

I.    PROSTITUTION  AND  ITS  CAUSES 11 

II.  PROSTITUTION* AND  ITS  MANIFESTATIONS...  20 

III.  THE  BUSINESS  SIDE  OF  PROSTITUTION 33 

IV.  RESULTS  OF  PROSTITUTION 44 

V.    THE  GOVERNMENT'S  FIGHT 62 

VI.  MEDICAL  MEASURES 83 

VII.  LAW  ENFORCEMENT 98 

VIII.  MEDICO-LEGAL  MEASURES 120 

IX.  EDUCATION 137 

X.  WELFARE  AND  REHABILITATION 148 

XI.    GOOD  GOVERNMENT 161 


VICE  AND  HEALTH 

CHAPTER  I 

PROSTITUTION  AND  ITS  CAUSES 

Prostitution  is  based  upon  a  funda- 
mental impulse,  and  is  but  the  com- 
mercialized or  misguided  manifesta- 
tion of  a  normal  physiological  func- 
tion. The  crime  involved,  so  far  as 
the  public  is  concerned,  is  not  so  much 
in  the  act  itself  but  in  its  promiscuity 
and  consequences. 

Thousands  of  men,  by  no  means 
limited  to  the  unmarried  group,  seek 
distractions  which  the  common 
woman  can  readily  supply;  and  vi- 
cious persons,  quick  to  see  the  advan- 
tage of  the  situation,  individually  and 
collectively  long  ago  sought  to  stock 

the  market  naturally  existing  and  at 

11 


p:  HEALTH' 


IS 

the  same  time  to  stimulate  a  greater 
one.  The  net  result  was,  that  in  the 
United  States  a  comparatively  few 
years  ago,  nearly  every  community  of 
any  size  either  possessed  an  open 
"  red-light "  district,  of  which  in 
some  instances  actual  boasts  were 
made,  or  had  its  quieter  section  to 
which  one  could  be  easily  directed. 

The  denizens  of  these  vice  neighbor- 
hoods were  recruited  in  a  number  of 
ways.  Some  were  forced  into  the  life 
through  faked  or  actual  marriages  to 
dissolute  men  whose  only  purpose  was 
to  victimize  and  profit  thereby ;  others 
by  sheer  inclination;  still  others  by 
unfortunate  steps  leading  to  seduc- 
tion, illegitimate  children  and  dis- 
grace; another  group  because  of 
poverty;  and  yet  others  through  a 
false  idea  of  the  ease  and  excitement 
of  a  gay  life  and  fine  feathers ;  and  a 
very  large  class  who  owing  to  a  low 


PROSTITUTION  A;ND-  i'I£.$Atf  SJ&S  13 

mentality  were  for  any  reason,  or  for 
no  reason  at  all,  inducted  into  activi- 
ties by  professional  procurers. 

It  must  be  realized  that  behind 
every  woman  of  vice  there  are  others 
sharing  in  her  proceeds.  Prostitu- 
tion is  very  definitely  a  business 
proposition.  The  corruption  funds 
of  the  manipulators  have  time  and 
again  proved  all  too  alluring  to  the 
police  and  other  officials,  and  thus 
legal  immunity  was,  and  is,  pur- 
chased. It  is  almost  axiomatic  that  a 
municipality  is  only  as  good  as  are  its 
politicians  and  police  force,  and  they 
are  strict  or  lax  depending  upon  the 
amount  of  general  interest  displayed ; 
and  indifference  has  been  the  rule. 
DesirejLor .gain  and  jmblic  unconcern 
may  therefore  be  considered  as  two 
of  the  basic  causes  of  prostitution. 

A  good  income  being  securable 
from  vice,  its  fostering  and  develop- 


14 


ment  was  but  a  natural  sequence.  In 
large  cities  "  rings  "  involving  men 
and  women  actually  engaged  in  the 
traffic  were  developed  ;  and  under  the 
paid  protection  of  the  police  were 
usually  allowed  to  flourish  unmolest- 
ed. A  number  of  these  groups,  as  will 
be  seen,  have  been  successfully 
broken.  Many  smaller  units,  while 
possibly  not  so  highly  organized,  still 
have  their  leaders  who  control  the 
major  portion  of  the  segregated 
business. 

The  relentlessness  with  which  pro- 
fessionals seek  recruits  is  almost  un- 
believable. With  an  average  of  three 
to  five  years'  activity  for  the  prosti- 
tute, a  definite  necessity  to  fill  the 
gaps  in  the  ranks  has  developed  a 
high  efficiency.  Small  wonder,  then, 
that  hundreds  of  girls  annually  "  dis- 
appear ",  that  fresh  young  faces  are 
constantly  being  fed  to  patrons  of 


PROSTITUTION  AND  ITfc>  CAUSES  15 

public  places,  and  new  women  are 
continually  arriving  at  houses  of 
prostitution  or  are  otherwise  engaged 
in  various  vice  enterprises.  At  the 
outset,  therefore,  it  must  be  thor- 
oughly appreciated  that  commercial- 
ized immorality  is  not  sporadic  but  is 
backed  by  power,  influence,  and  the 
complexities  of  a  modern  business 
organization. 

After    eliminating   feeble-minded- 
ness,   the.  dance  hall, 


liquor  adjunct  removed,  is  one  of  the 
most  potent  vice  f  actorsythe  niain  ob- 
jection to  this  institution  is  the  com- 
pany to  be  found  there.  Many  young 
men  who  act  with  comparative  decen- 
cy among  their  own  set,  resort  to  the 
public  dance  to  prey  upon  the  pretty 
young  girls  frequenting  them.  Be- 
sides, men  and  women,  especially  in 
the  larger  cities,  seek  such  places  for 
outright  recruiting  purposes.  Permit 


16 


a  young  woman  to  habitually  patro- 
nize these  resorts,  no  matter  how 
decently  conducted  they  may  claim  to 
be,  her  chastity  and  possibly  her  fut- 
ure life  are  in  danger. 

Thejjii^nncMU--a6  an  element  of 
vice,  looms  large.  Joy-rides  are  pro- 
lific of  harm,  even  with  the  urging 
appeal  of  liquor  now  minimized. 
Mothers  permit  their  daughters  to 
accompany  young  men  upon  excur- 
sions leading  to  the  dark  and  solitary 
rendezvous,  who  would  not  counte- 
nance their  remaining  alone  in  a 
dimly-lighted  room  with  the  same 
escort;  and  many  girls  without  par- 
ental knowledge  make  a  casual  ac- 
quaintanceship with  men  in  cars  who 
"  cruise  "  the  streets  for  willing  vic- 
tims. In  numerous  instances  the  first 
downward  step  has  thus  been  taken. 
Again,  many  a  young  woman  after  a 
hard  day's  work  in  a  store  or  factory, 


PROSTITUTION  AND  ITS  CAUSES  17 

has  innocently  sought  amusement, 
and  in  so  doing  has  permitted  herself 
to  be  taken  to  places  of •  questionable 
character  such  as  shady  restaurants, 
cabarets,  and  road-houses,  there  to  be 
gradually,  if  not  abruptly  educated  to 
the  false  idea  that  to  work  for  ten  or 
fifteen  dollars  a  week  was  foolish 
when  three  or  four  times  as  much 
could  be  "  made  easily  ". 

One  of  the  fundamental  causes  of 
moral  dereliction  rests  with  the^ome 
andjtS-Siirroundings.  Crgseded  tene- 
ment existence  and  JDOQIL  JioiisingL 
conditions  generally,  sap  the  stamina 
ofmanyTtEus  developing  a  predispo- 
sition to  weaken  before  the  onslaughts 
of  evil.  Even  in  the  higher  social 
strata,  lack  of  training  in  self  control, 
in  understanding  of  the  sex  impulse, 
and  of  preventive  knowledge,  coupled 
with  an  over  confidence  of  parents  in 
the  moral  stability  of  their  children, 


18  VICE  AND  HEALTH 

have  led  to  dire  consequences.  More- 
over, the  general  independence  of  the 
modern  youth  and  maid,  who  as  a 
care-free  and  pleasure-seeking  class 
has  openly  revolted  at  the  "  old 
fashioned  ideas  "  of  life  and  living, 
comes  in  for  its  toll.  And  finally, 
youth  is  not  so  protected  as  formerly. 
Immature  girls  are  filling  offices  and 
factories.  The  old  time  safeguards 
of  sex  have  therefore  considerably 
broken  down;  and  thus  unrestricted 
and  unconstrained  daily  mingling  of 
men  and  women  creates  possibilities 
leading  to  illicit  ventures  for  those 
disposed  in  that  direction. 

Notably  in  New  York  and  Chicago 
investigations  undertaken  some  years 
ago  resulted  in  bringing  before  inter- 
ested people  astonishing  facts  in  con- 
nection with  prostitution  as  a  traffic ; 
and  the  large  vice  districts  of  those 
cities  were  consequently  eliminated. 


PROSTITUTION  AND  ITS  CAUSES  19 

Occasionally  a  reform  wave  would 
strike  a  smaller  place,  resulting  in  a 
general  exodus  of  vice  habitues,  who 
immediately  returned  to  their  former 
haunts  when  the  official  order  had 
spent  its  force. 

At  the  outbreak  of  hostilities  with 
Germany  the  United  States  took  a 
definite  and  systematic  stand  against 
prostitution  which  extended  over  the 
entire  land;  but  despite  concerted 
action  by  the  federal  and  state  gov- 
ernments from  that  time  up  to  the 
present,  many  cities  still  have  more 
or  less  well  defined  vice  localities. 
The  reasons  for  this  will  be  explained 
in  a  subsequent  chapter. 


CHAPTER  II 

PROSTITUTION  AND  ITS  MANIFESTATIONS 

Commercialized  vice  is  plastic;  it 
adapts  itself  when  it  must  to  condi- 
tions. The  most  usual  form,  how- 
ever, is  to  be  found  in  a  group  of 
women  living  in  a  certain  neighbor- 
hood where  the  business  is  either 
openly  flaunted  by  the  aid  of  a  red- 
light  and  window  solicitation,  or  is 
more  discreetly  operated,  depending 
upon  the  official  attitude.  Such  places 
are  usually  located  in  the  side  streets 
and  alleys,  and  frequently  near  rail- 
roads. In  seaports  a  number  of  them 
are  close  to  the  water  front.  These 
localities  are  known  as  "  districts  ': 
or  "  the  line  ". 

A  district  marks  the  last  step  in  the 

demoralization  of  women,  many  of 
20 


PROSTITUTION  AND  ITS  MANIFESTATIONS  21 

whom  need  institutional  care  rather 
than  the  psuedo-correctives  of  the 
police  court  with  its  usual  fine  and 
infrequent  jail  sentence. 

It  is  in  such  places  that  liquor  may 
be  yet  obtained  at  bankrupting 
prices ;  it  is  here  one  will  find  congre- 
gated at  certain  hours  the  men  who 
"  farm  "  the  women  and  solicit  for 
them;  it  is  here  that  debauchery 
reaches  its  lowest  level ;  and  it  is  here 
that  blasting  disease  is  transmitted  to 
the  outside  world.  But  with  all  of 
that,  it  is  prostitution's  popular  and 
favorite  form. 

It  appears  to  be  a  very  general 
opinion  that  such  neighborhoods, 
with  their  known  houses,  measurably 
reduce  the  existence  of  other  vice 
manifestations.  Nothing  is  further 
from  the  truth.  It  is  quite  out  of  the 
question  to  limit  the  majority  of  the 
>rostitutes  to  one  locality.  This  fact 


22  VICE  AND  HEALTH 

was  well  illustrated  in  certain  second 
class  cities  wherein  recent  investiga- 
tions proved  segregated  districts  to 
be  in  full  swing.  The  "  high  visi- 
bility "  of  these  places  had  dimmed 
official  and  civic  eyes  to  the  fact  later 
disclosed,  namely,  that  over  forty=fi.Y.e 
r>£r-eefit.  (a  conservative  estimate  )jof 
the_cpmmon  women  in  thes^communi- 
ties  lived  outside  .-jo£^thej>ale>  It- 
should  be  evident  therefore  that 
"  segregation  does  not  segregate"; 
on  the  contrary  the  presence  of 
grouped  houses  of  assignation  merely 
stimulates  the  commercial  feature, 
develops  an  added  peril  to  virtue  and 
health,  and  dulls  vision  to  the  other 
forms  of  vice. 

It  is  also  said  that  the  prostitute  is 
necessary  to  protect  the  chastity  of 
other  women.  Such  a  statement,  even 
if  sound,  could  have  no  ethical  justi- 
fication; but  the  case  really  works 


PROSTITUTION  AND  ITS^MANIFESTATIONS  23 

the  other  way — more.  li££ntiousness, 
more  license. 

+**"~m  --^ 

In  a  large  northwest  city*  a  reign 
of  violence  and  assault  took  place 
upon  the  closing  of  its  several  vice 
localities ;  women  were  terrorized,  and 
law  and  order  were  at  low  tide.  When 
the  police  corralled  the  offenders,  it 
was  discovered  that  they  were  paid 
hirelings  of  the  underworld  whose 
only  purpose  was  to  win  the  public 
over  to  the  idea  of  the  necessity  of 
vice  as  a  matter  of  social  protection. 
The  notorious  failure  of  this  plot  was 
a  terrific  boomerang.  No  district  has 
been  tolerated  in  that  city  for  years, 
and  other  forms  of  prostitution  have 
been  greatly  minimized.  Women  are 
as  safe  there  as  in  any  other  Ameri- 
can community.  Moreover,  violence 
as  an  argument  against  the  elimina- 
tion of  commercial  vice  has  never 

*  Seattle,  Wash. 


24  VICE  AND  HEALTH 

been  attempted  elsewhere.  Mothers, 
daughters  and  wives  need  have  no 
fear  for  themselves  if  a  district  is 
closed;  a  very  vital  concern  should 
exist,  however,  if  a  district  and  prosti- 
tution generally,  are  allowed  to 
flourish. 

With  the  segregation  theory  goes 
its  partner,  medical  regulation. 
Again,  there  is  no  such  thing.  The 
vaunted  medical  inspection  (upon 
which  certificates  of  health  are  given 
and  then  displayed  by  the  prostitute 
as  an  earnest  of  her  good  physical  con- 
dition) is  usually 


Even  if  the 


examination  is  honest,  means  are  at 
hand  to  camouflage  certain  condi- 
tions. And  further,  assuming  that 
there  is  no  open  evidence  of  disease, 
in  a  few  hours  a  prostitute  may  be- 
come infectious. 


PROSTITUTION  AND  ITS  MANIFESTATIONS  25 

In  1917,  in  a  Pacific  Coast  city* 


>^ 


ninety-seven  per  cent,  of  the  common 
women  we]^loun3^to]be  infected.  In 
an  eastern  city  t,  in  1915,  ninety-six 
per  cent,  of  the  prostitutes  had  a 
venereal  Disease.  Medical  certificates 
were^  freely  used  by  these  women^  In 
a  small  locality,  in  1919,  there  were 
three  houses  with  twenty  prostitutes, 
each  of  whom  had  a  physician's  cer- 
tificate, and  eighteen  of  them  had 
syphilis  or  gonorrhea,  or  both. 

That  the  clandestine  and  "  char- 
ity "  girl  may  also  be  infected,  as  she 
frequently  is,  does  not  lessen  the  out- 
standing fact  that  segregated  districts 
and  disease  go  hand  in  hand.  Then, 
too,  while  the  clandestine  and  charity 
girl  expose  comparatively  few,  the 
known  prostitute  exposes  hundreds. 
In  a  raid  upon  a  house  containing 

*  San  Francisco,  Cal. 
t  Baltimore,  Md. 


26  VICE  AND  HEALTH 

three  women,  all  of  whom  were  syphi- 
litic, cards  punched  by  the  madam 
indicating  a  payment  in  advance  for 
the  prostitute  desired,  were  seized 
and  used  in  court  as  evidence ;  th.ese 
contained  forty-nine,  thirty-seven, 
and  twenty-eight  punch  marks  respec- 
tively for  the  day's  activities.* 

"  What  always  has  been,  always 
will  be  "  is  an  assertion  frequently 
heard  in  support  of  a  district's  con- 
tinuance ;  but  immutability  has  proved 
to  be  but  a  phantom  in  the  face  of  a 
virile  attack. 

Variations  of  the  above  reasons  are 
repeatedly  advanced,  and  like  the 
main  arguments,  apparently  possess 
a  certain  logical  basis  which  thus 
makes  them  dangerous.  The  propa- 
ganda of  the  underworld  in  this  re- 
spect has  been  most  effective;  conse- 

*  See  "  The  Case  Against  the  Red  Light ",  a 
pamphlet  published  by  the  American  Social  Hy- 
giene Association  and  State  Boards  of  Health. 


PROSTITUTION  AND  ITS  MANIFESTATIONS  27 

quently  there  are  thousands  of  men 
and  women  in  the  United  States,  well 
meaning  people,  who  being  casually 
attracted  to  the  question,  are  con- 
vinced that  the  segregated  district  and 
its  known  house  of  prostitution  is 
vice's  safest  form.  Public  opinion  is 
in  this  manner  fortified  in  an  attitude 
of  tolerance  which  truth  alone  can 
finally  dissipate. 

General  Pershing,  whose  experi- 
ence with  the  medical  regulation  of 
vice  in  Mexico  and  with  the  various 
phases  of  control  applied  to  the 
American  Expeditionary  Forces, 
qualifies  him  to  speak,  has  thus 
summed  up  the  case  against  segrega- 
tion: "Many  of  us  who  have  experi- 
mented with  licensed  prostitution  or 
kindred  measures,  hoping  thereby  to 
minimize  the  physical  evils,  have 
been  forced  to  the  conclusion  that 
they  are  generally  ineffective.  Abra- 


«8  VICE  AND  HEALTH 

ham  Flexner  has  argued  the  case  so 
convincingly  that  on  the  scientific  side, 
it  seems  to  me,  there  is  no  escape  from 
the  conclusion  that  what  he  terms 
4  abolition 9  as  distinguished  from 
i regulation'  is  the  only  effective  mode 
of  combating  this  age-old  evil." 

Hotels  are  being  generally  used  for 
the  purposes  of  clandestine  prosti- 
tution, and  in  a  great  many  instances 
with  perfect  safety.  The  conditions 
found  in  large  hostelries  are  particu- 
larly adaptable  to  professional  im- 
morality. The  hotel  lobby  or  corridor 
becomes  an  attractive  setting  for  the 
marketing  of  wares,  which  is  usually 
aided  by  bell-boys  or  procurers ;  and 
once  met,  the  contracting  parties  have 
little  difficulty  in  securing  accomoda- 
tions,  if  not  at  the  assignation  point 
then  at  some  near-by  house,  the  de- 
tails of  baggage  being  previously 
arranged. 


PROSTITUTION  AND  ITS  MANIFESTATIONS  29 

The  small  and  disorderly  hotel,  of 
which  there  are  several  in  every  city 
of  any  size  and  many  in  the  larger 
ones,  operates  either  boldly  or  clan- 
destinely, as  conditions  warrant. 
Such  resorts,  irrespective  of  any  dis- 
trict, contain  many  of  the  disadvan- 
tages of  the  segregated  form  and  are 
less  likely  to  be  disturbed  by  munici- 
pal interference.  A  prostitute  will 
remain  at  one  of  these  places  for  a 
week  or  so,  then  move  on  to  another, 
thus  operating  in  a  cycle  which  may 
involve  several  cities.  Her  " guests", 
who  have  been  procured  by  her  own 
efforts  upon  the  streets,  or  have  been 
steered  to  her  by  the  hotel  boys,  are 
entertained  in  her  room. 

The  low-grade  apartment  house  is 
quite  akin  to  the  disorderly  hotel, 
with  the  difference  that  detection  is 
somewhat  less  easy  in  the  former  than 
in  the  latter. 


80  VICE  AND  HEALTH 

Booming  houses  ofttimes,  when 
revealed,  are  places  of  accomodation 
where  regular  "  lodgers  "  are  dis- 
creetly made  available.  These  estab- 
lishments differ  from  the  usual  house 
of  prostitution  in  that  they  have  no 
parlor  attachment.  Besides,  the  mad- 
am is  likely  to  have  certain  women  on 
her  list,  living  privately,  who  are 
readily  summoned  by  telephone. 
The  latter  class  is  sometimes  com- 
posed of  women  who  are  legitimately 
employed  during  the  day  but  for  vari- 
ous reasons  are  willing  to  quietly 
prostitute  themselves.  Houses  hav- 
ing no  residents  but  to  which  women 
are  summoned,  are  known  as  "  call ' 
resorts. 

One  of  the  most  general  manifes- 
tations of  clandestine  prostitution  is 
observed  in  street  solicitation.  This 
may  take  the  direct  form  of  the  spok- 
en word  or  the  more  tactful  flirtation. 


PROSTITUTION  AND  ITS  MANIFESTATIONS  31 

If  the  woman  does  not  happen  to  be  a 
regular  inmate  she  will  invariably 
lead  her  victim  to  a  place  designed  for 
the  purpose  of  catering  to  transient 
and  illicit  accommodations. 

The  automobile,  especially  the  "f  or- 
hire  "  car,  is  a  definite  element  in  vice 
activity.  The  chauffeur  frequently 
has  several  women  who  are  subject  to 
his  call;  and  the  automobile  being 
driven  to  a  secluded  spot,  is  used  as 
the  locus  operandi,  when  necessary. 

And  lastly,  there  is  the  quiet  girl 
who  to  all  appearances  lives  decently 
yet  who  commercializes  herself. 

While  the  various  phases  men- 
tioned above  comprehensively  cover 
the  commercial  manifestations  it 
must  be  remembered  that  hundreds  of 
young  women  become  charitably  pro- 
miscuous ;  they  are  decidedly  hard  to 
control,  and  present  as  great  a  prob- 
lem as  the  commercial  counterpart. 


34  VICE  AND  HEALTH 

Thus  it  appears  that  the  difficulties 
in  eradicating  prostitution  are  more 
general  than  might  at  first  be  sus- 
pected, and  are  by  no  means  re- 
stricted to  a  segregated  locality.  It 
follows  that  numerous  points  of 
attack  are  indicated;  these  must  be 
planned  with  care  and  be  persistently, 
conscientiously  and  generally  pur- 
sued. Spasmodic  local  efforts  make 
good  press  material  but  do  not  hit  at 
the  heart  of  the  matter.  Constant 
suppression  of  vice  in  all  of  its  forms 
in  every  locality  is  essential  to  any 
reasonable  advance  against  the  prob- 
lem. Modern  methods,  among  other 
things,  involve  just  that. 


CHAPTER  III 

THE  BUSINESS  SIDE  OP  PROSTITUTION 

Prostitution  pays  and  pays  hand- 
somely. Finance  is  its  life,  gain  its 
very  heart.  Eliminate  the  dollar  and 
the  elaborate  machinery  sustaining 
the  traffic  disappears. 

In  districts  the  girl  does  not  rely 
upon  her  own  energies  for  trade.  She 
is  regularly  established,  and  has  her 
interested  parties  on  the  outside  who 
are  masters  in  the  art  of  information. 
Men  are  engaged  for  the  most  part, 
and  operate  occasionally  directly; 
that  is,  without  any  visible  means  of 
support,  but  more  often  under  the 
blind  of  some  kind  of  employment. 
The  automobile  has  created  an  excel- 
lent shield  for  this  activity. 

As  in  the  old  horse-cab  days,  the 
driver  of  the  modern  public  convey- 

3  33 


34  VICE  AND  HEALTH 

ance  is  well  informed  on  vice  locali- 
ties; and  for  his  regular  fare  plus  a 
bonus  will  take  the  inquirer  to  them. 
After  landing  his  patron  he  subse- 
quently receives  an  additional  com- 
pensation from  the  landlady  whose 
establishment  he  favors.  While  all 
taxi-cab  drivers  are  not  connected 
with  the  prostitutes,  and  companies 
of  good  standing  penalize  by  im- 
mediate dismissal  any  employee  oper- 
ating illegally,  this  method  of  obtain- 
ing admission  to  the  underworld  may 
nevertheless  be  relied  upon  for  satis- 
factory results. 

Policemen  also  frequently  direct 
inquiring  strangers.  In  short,  a  dis- 
trict is  one  of  the  easiest  neighbor- 
hoods in  a  city  to  locate,  if  one  exists. 

A  distinction,  however,  must  be 
drawn  between  the  occasional  inform- 
ant and  the  out-and-out  "  cadet  ". 
The  latter  is  a  despicable  person  who 


THE  BUSINESS  SIDE  OF  ^PROSTITUTION    35 

is  directly  controlling  one  or  more 
women,  in  whose  proceeds  he  largely 
shares,  if,  indeed,  he  does  not  get  all 
of  them.  This  is  a  matter  of  personal 
slavery  and  is  most  difficult  to  ex- 
plain. The  power  exerted  over  the 
unfortunate  girl  is  absolute,  and 
cruelty  appears  to  be  an  essential  to 
its  success.  Her  type  of  mind  trans- 
lates a  beating  into  displayed  affec- 
tion, though  the  logic  involved  is 
quite  incomprehensible. 

Once  inside  of  the  resort  the  will- 
ing victim  pays  a  dollar  or  more  for  a 
drink  of  poor  whisky,  usually  treat- 
ing the  inmates  in  the  parlor  who  are 
at  leisure,  they  however  sipping  cold 
tea  at  the  same  exorbitant  price. 
If  the  man  has  plenty  of  money 
and  can  be  induced  to  become  suf- 
ficiently intoxicated  he  may  later 
find  himself  penniless  by  reason  of 
his  indiscretion. 


36  VICE  AND  HEALTH 

It  has  long  since  been  demonstrated 
that  with  the  high  rents  and  various 
extortions  connected  with  the  busi- 
ness, resorts  are  compelled  to  rely 
upon  other  than  the  up-stairs  fees. 
Liquor,  therefore,  has  always  been 
considered  a  necessary  adjunct.  The 
"  underground  railroad  "  still  deliv- 
ers this  commodity  freely  to  such 
places.  However,  with  the  existence 
of  prohibitive  prices  some  madams 
(as  the  proprietresses  are  styled) 
have  successfully  adapted  themselves 
to  national  prohibition  by  selling  soft 
drinks  at  a  fancy  figure,  and  thus 
manage  to  conduct  a  profitable  con- 
cern. Incidentally,  it  may  be  added 
that  higher  charges  prevail  for  privi- 
leges than  formerly  obtained. 

It  is  unnecessary  to  discuss  the 
details  of  the  internal  economy  of  an 
establishment,  except  to  remark  that 
by  a  clever  charge  system  for  fashion- 


THE  BUSINESS  SIDE  OF  PROSTITUTION    37 

able  apparel,  peddled  by  agents  cater- 
ing to  the  trade,  and  by  the  usual  fees 
for  board  and  lodging,  the  bulk  of  the 
earnings  of  the  inmates  finds  its  way 
into  the  hands  of  the  madam,  who,  in 
turn,  surrenders  a  large  portion  of  it 
to  the  landlord.  The  men  directly 
backing  the  resorts  come  in  for  their 
share;  and  the  "  friends  "  of  the 
girls  receive,  either  in  the  form 
of  gifts  or  money,  the  small  amount 
net  to  them. 

In  the  larger  cities  the  tribute  sys- 
tem is  sometimes  operated  upon  an 
elaborate  scale;  the  "  higher-ups  r 
down  to  the  precinct  policeman  fre- 
quently sharing  in  the  profits.  Re- 
peated exposure  has  to  some  degree 
minimized  this  practice  but  the  oc- 
casional scandal  and  convictions  in 
the  courts  for  this  type  of  extortion, 
suggest  that  it  yet  flourishes. 

As  has  been  observed,  the  necessity 


88  VICE  AND  HEALTH 

of  keeping  the  ranks  in  the  district 
filled  with  a  marketable  product  re- 
sulted in  an  elaborate  scheme  of  pro- 
curation. It  is  difficult  to  believe 
that  men  and  women  could  become  so 
utterly  demoralized  as  to  prey  upon 
virtue  for  gain.  This  fact  is,  never- 
theless, true.  Procurers  still  seek 
recruits  from  farms  and  villages; 
newspaper  advertisements  offering 
"  congenial  work  and  good  hours  " 
are  successfully  employed;  factories 
are  combed  for  susceptible  material; 
and  tenement  districts  scoured  for 
possibilities.  Even  foreign  countries 
are  drawn  upon;  the  international 
procurer  negotiating  the  passage  of 
the  attractive  Danish,  Polish  or 
Italian  girl  to  this  country  through 
the  golden  lure.  Despite  national  and 
international  regulations,  trans-At- 
lantic liners  are  met  and  unsophisti- 
cated immigrant  girls  are  occasion- 


THE  BUSINESS  SIDE  OF  PROSTITUTION    39 

ally  carried  off  on  one  pretence  or 
another  into  a  life  of  shame.  And 
for  all  this  nefarious  business  large 
sums  are  paid. 

While  "  white  slavery  "  formerly 
played  a  part  in  commercial  vice,  and 
chastity  was  thus  sometimes  defeated 
by  means  of  a  padlock;  the  indirect 
method,  because  of  its  safety,  has 
always  been  the  more  popular  way 
employed  to  break  a  woman's  morale. 

It  is  quite  true  that  in  many  cities 
"  districts  "  are  ostensibly  closed  and 
in  others  are  running  in  an  admitted- 
ly crippled  fashion,  but  the  demand 
for  inmates  still  makes  procuration 
financially  attractive,  and  a  nation- 
wide activity.  However,  it  is  not 
over-enthusiasm  which  suggests  that 
prostitution  as  a  centralized  institu- 
tion is  actually  on  the  wane.  The 
signs  of  the  times  are  unmistakably 
pointing  in  that  direction. 


40  VICE  AND  HEALTH 

It  is  not  an  indictment  against 
either  the  American  girl  or  American 
soldier,  rather  it  is  merely  the  state- 
ment of  a  psychological  fact  applic- 
able to  the  civilized  race  everywhere, 
but  it  remains  that  a  certain  lure  of 
the  uniform  and  the  excitement  inci- 
dent to  the  World  War  resulted  in 
thousands  of  moral  casualties  on  this 
side  of  the  Atlantic. 

Many  young  women,  with  no  im- 
moral tendencies,  were  led  into  sex 
experiences  which  were  conceivably 
not  within  the  realm  of  their  con- 
scious possibilities  prior  to  the  recent 
conflict;  especially  was  this  true  of 
those  who  at  the  time  were  outside  of 
the  control  of  parents,  either  by 
reason  of  their  indifference  or  on 
account  of  living  elsewhere.  Also, 
the  girl  who  would  naturally  fall  into 
such  a  life  became  an  easy  victim  and 
thus  developed  into  a  "  charity " 


THE  BUSINESS  SIDE  OF  PROSTITUTION    41 

proposition.  The  war  ended,  the 
military  rainbow  faded,  but  the  expe- 
rience was  left — and  the  practice  con- 
tinued. Fine  clothes  and  a  "  good 
time  "  were  always  to  be  had.  Excite- 
ment had  become  a  necessary  feature 
of  life  and  the  downward  step  was 
easy  as  well  as  rapid^Especiattf 
were  these  things  true  in  communi- 
ties near  large  groups  of  soldiers 
or  sailors. 

Hotels  had  been  used  before  with 
perfect  safety  and  hotels  could  be 
used  again ;  this  time  for  money.  As 
a  consequence  there  is  today  a  large 
class  of  women  posing  as  legitimate 
guests,  frequenting  the  better  and 
low  grade  houses  for  commercial  pur- 
poses. That  a  loose  ring  exists  and 
that  by  a  careful  working  out  of  itin- 
eraries girls  are  floated  from  one 
locality  to  another,  there  can  be  no 
question;  though  many  of  them  are 
operating  independently. 


42  VICE  AND  HEALTH 

Respected  and  otherwise  respect- 
able citizens  have  buildings  or  rooms 
which  are  rented  out  promiscuously 
for  a  term.  Corporations  and  small 
companies  evade  the  question  by  hid- 
ing behind  their  charters  and  conse- 
quently lease  to  women,  or  men  and 
women,  without  more  than  a  perfunc- 
tory inquiry  as  to  their  means  of  live- 
lihood and  general  reputation. 

The  fact  that  this  business  pays  is 
impressed  not  only  upon  the  men  and 
the  women  in  the  traffic  but  upon 
municipal  officials  as  well.  Today 
many  cities  in  this  country  are 
virtually  licensing  vice.  The  old  time 
attitude  toward  the  scarlet  woman 
and  those  who  follow  in  her  train  still 
obtains;  the  police  court  desires  to 
make  a  financial  showing  under  the 
belief  that  large  sums  extracted  from 
offenders  in  fines  is  synonymous  with 
justice  and  efficient  police  perform- 


THE  BUSINESS  SIDE  OF  PROSTITUTION    43 

ance.  Money,  however,  is  a  small 
item  in  the  life  of  a  prostitute  and, 
like  disease,  is  as  apt  to  be  in  her 
possession  as  not.  If  financially 
embarrassed,  her  "  friend  "  mysteri- 
ously appears  and  pays  the  fine, 
which  results  in  the  offender's  im- 
mediate return  to  the  streets  for 
further  operations.  The  city  has  thus 
added  an  extra  fifteen  or  twenty- 
five  dollars  to  its  account  and  the 
prostitute  has  purchased  the  right 
to  ply  her  trade  for  another  few 
months,  when  she  will  be  caught  and 
fined  again.* 

It  is  therefore  observed  that  from 
the  procurer's  first  concern  down  to 
the  inevitable  interest  of  justice, 
money  is  the  motive  and  the  prize. 

*  The  above  criticism  is  based  on  averages ; 
large  cities  such  as  Chicago,  New  York,  Phila- 
delphia and  Pittsburgh  possess  municipal,  and! 
morals  courts  whose  function  involves-  'the  handling- 
of  sex-delinquents  along  most  modern  and 
approved  methods. 


CHAPTER  IV 

RESULTS  OF  PROSTITUTION 

It  is  evident  from  the  preceding 
pages  that  prostitution  as  a  demoral- 
izing agency  is  one  of  the  big  prob- 
lems with  which  nations  have  to  con- 
tend. This  has  been  realized  to  a  cer- 
tain extent  for  a  long  time. 

Professional  reformers,  clergymen 
and  others  have  attempted  methods 
of  suppression.  Moral  suasion,  public 
opinion  and  legislative  enactment 
have  been  applied  to  the  end  that  vice 
should  be  eliminated  as  vice ;  but  the 
lasting  advantages  of  these  various 
forms  of  attack  have  been  slight. 

The  World  War  created  a  very  dif- 
ferent angle  of  approach,  based  at  the 
time  upon  sheer  military  necessity. 
This  offensive,  while  recognizing  the 

44 


RESULTS  OF  PROSTITUTION  45 

value  of  morals  as  such  and  the 
potency  of  effective  punishment,  sub- 
merged these  matters  to  the  basic  fact 
of  national  preservation. 

Never  before  in  the  country's  his- 
tory were  conditions  such  as  to  make 
possible  a  discovery  of  the  terrifically 
vital  results  of  prostitution.  With  an 
emphasis  startling  in  its  force,  the 
medical  men  of  the  draft  boards  and 
of  the  armed  services  in  camp  and 
Navy  Yard  were  confronted  with 
venereal  disease.  Conscription,  be- 
ing comprehensive  as  to  classes, 
brought  the  average  youth  from  all 
strata  of  our  national  life  before  the 
rigidly  inspecting  eye  of  the  official 
physician;  and  the  prevalence  of 
syphilis  and  gonorrhea  thus  found  to 
be  coming  direct  from  the  civilian 
communities,  compelled  national 
interest. 


46  .VICE  AND  HEALTH 

In  seeking  causes  for  the  physical 
condition  of  our  emergency  army,  a 
prompt  and  thorough  investigation 
by  the  government  was  conducted, 
which  indicated  beyond  question  that 
the  main  source  of  infection  was  pros- 
titution, either  professional  or  ama- 
teur. A  procedure  to  control  this 
situation,  to  be  later  explained,  was 
adopted  by  the  authorities  at  Wash- 
ington. However,  the  main  point  is, 
that  the  medical  world  was  at  last 
alive  to  a  situation  hitherto  suspected 
but  never  before  fully  realized, 
namely,  that  while  moral  delinquency 
annually  ruined  a  large  number  of 
women  and  girls,  this  form  of  vice 
was  a  colossal  disease  problem  and  as 
such  was  insidiously  devitalizing 
the  race. 

The  following  statements  taken 
from  the  Standard  Statistics  on  Gon- 


RESULTS  OF  PROSTITUTION  47 

orrhea  and  Syphilis  *  should  be  im- 
pressive : 

33  per  cent,  of  all  prostitutes  are 
feeble-minded. 

90  per  cent,  of  all  syphilitic  infec- 
tions in  men  are  derived  from 
the  prostitute,  either  profes- 
sional or  amateur. 

50  per  cent,  of  all  syphilitic  women 
are  infected  innocently. 

70  per  cent,  of  women  who  came  to  *) 
the    New    York    hospital    for 
venereal  disease  treatment  were 
respectable  married  women  in- 
fected by  their  husbands. 

85  per  cent,  of  married  women  who  \ 
have  syphilis  have  contracted  it 
from  their  husbands. 

15  per  cent,  of  all  first  admissions 
to  the  New  York  State  hospital 
for  the  insane  are  traceable 
to  syphilis. 

*  Pamphlet  published  by  The  American  Social 
Hygiene  Association, 


/ 


48  VICE  AND  HEALTH 

100  per  cent,  of  all  cases  of  paresis 
(general  paralysis)  are  directly 
traceable  to  syphilis. 
per  cent,  of  all  cases  of  locomo- 
tor  ataxia  are  directly  traceable 
to  syphilis. 

98  per  cent,  of  prostitutes  (white) 
have  at  least  one  venereal 
disease. 

19.6  per  cent,  of  all  routine  hos- 
pital cases  (white)  are  syphi- 
litic. 

2    out  of  every  13  deaths  in  the 
United  States  today  are  directly 
or  indirectly  caused  by  syphilis. 
$628,750,000  is  the  yearly  cost  of 
supporting  prostitution,  itemized  as 
follows  : 

$165,250,000  —  Annual  sum  paid  to 
prostitutes.* 

$51,000,000—  Care  of  insane  due  to 
venereal  disease. 

*  Figure  based   on  estimate  of  50,000   prosti- 
tutes receiving  three  customers  a  day  at  $3.00  each. 


RESULTS  OF  PROSTITUTION  40 

$97,000,000 — Annual  economic  loss 
on  insane. 

$3,000,000— Cost  of  blindness  due 
to  venereal  disease. 

$3,000,000— Detention  of  prosti- 
tutes. 

$300,000,000— Economic  loss  caused 
by  venereal  infection  in  the  general 
population. 

$10,000,000— Treatment  of  new 
cases  among  men. 

In  addition  to  the  above  amount, 
large  expenditures  for  courts,  police, 
jails,  hospitals,  clinics,  and  for  many 
operations  on  women  must  be  con- 
sidered. 

Doctor  Edward  Martin  says: 

"  In  the  line  of  present  knowl- 
edge, syphilis  is  probably  more  gross- 
ly destructive  of  human  health,  effi- 
ciency, and  happiness  than  is  tu- 
berculosis. 

4  *  It  is  entirely  controllable ;  is  prob- 


50  VICE  AND  HEALTH 

ably  curable,  if  taken  in  its  early 
stages;  therefore,  there  is  no  health 
problem  more  urgent  in  its  need  and 
more  completely  within  the  power  of 
a  profession  and  a  community  work- 
ing together,  than  the  control  of 
syphilis. " 

Dr.  C.  C.  Pierce,  Assistant  Surgeon 
General  U.  S.  Public  Health  Service, 
has  remarked: 

"  When  the  people  of  the  United 
States  realize  the  prevalence  of  gonor- 
rhea and  syphilis  among  all  classes  of 
society ;  when  they  appreciate  the  ex- 
tent of  the  social  damage  caused  by 
these  diseases ;  when  they  understand 
that  thousands  of  innocent  women 
and  children  are  being  martyred  by 
them  and  that  this  suffering  is  alto- 
gether unnecessary,  the  venereal  dis- 
eases are  doomed.  Then  at  last  the 
present  program  of  the  State  boards 
of  health  for  the  eradication  of  gonor- 


RESULTS  OF  PROSTITUTION  51 

rhea  and  syphilis  will  be  effective,  and 
just  as  typhoid  fever,  yellow  fever 
and  other  devastating  plagues  have 
been  brought  under  control,  so  it  will 
be  possible  to  control  these  diseases. 
But  until  the  people  of  the  United 
States  are  fully  awake  to  the  situa- 
tion, progress  will  be  slow.  It  is  for 
them  alone  to  say  how  soon  this 
scourge  shall  end." 
Doctor  Ellen  C.  Potter  states : 
"  The  venereal  diseases  undoubt- 
edly constitute  the  most  serious  men- 
ace to  the  mother  and  child. 

* '  Any  group  of  men  and  women  who 
are  concerned  with  the  welfare  of 
children  must,  of  necessity,  concern 
themselves  with  venereal  disease,  and 
a  constructive  program  of  education, 
recreation,  medical  care  and  law  en- 
forcement is  essential  if  these  dis- 
eases are  to  be  prevented  and  con- 
trolled." 


58  VICE  AND  HEALTH 

Dr.  S.  Leon  Grans  makes  this  state- 
ment: 

'  '  The  venereal  diseases  have  caused 
an  inestimable  amount  of  suffering 
to  the  innocent  wife  and  child.  In 
most  instances  it  has  been  the  result 
of  ignorance  and  unintentional  action 
of  the  individual  originally  infected." 

Major  Edgar  S.  Everhart,  M.C., 
in  charge  of  Venereal  Disease  Con- 
trol, Pennsylvania  National  Guard, 
has  said : 

"  Venereal  diseases  with  their 
attendant  evils  are  responsible  for  a 
greater  number  of  deaths  than  are  the 
spectacular  diseases,  influenza  and 
yellow  fever.  Gonorrhea  by  prevent- 
ing conception,  and  syphilis  by  caus- 
ing the  death  of  the  unfortunate  indi- 
vidual are  in  truth  the  scourges  of  the 
present  day." 

Dr.  J.  W.  Williams  found  11.2  per 
cent,  positive  Wasserman  reactions 


RESULTS  OF  PROSTITUTION  53 

(indicating  syphilis)  among  four 
hundred  pregnant  women. 

Dr.  C.  P.  Jean  claims  5-6  per  cent, 
of  infants  of  the  poorer  class  in  this 
country  have  syphilis ;  older  children 
from  2-3  per  cent. 

Dr.  John  H.  Stokes,  of  the  Mayo 
clinic,  is  authority  for  the  follow- 
ing statements : 

"51-60  per  cent,  of  the  male  popu- 
lation of  the  United  States  has  or 
have  had  gonorrhea. 

"  The  genital  transmission  of 
syphilis  covers  from  80-90  per  cent, 
of  all  cases.  About  50  per  cent,  of  the 
infections  of  married  women  have 
seemed  to  me  to  be  contracted  in 
marriage. 

"  About  5  per  cent,  of  the  children 
who  are  idiotic  are  so  because  of 
syphilis. 

"  Williams  estimated,  it  will  be 
recalled,  that  one  hundred  men  in- 


54  VICE  AND  HEALTH 

sane  from  syphilis,  represented  a  net 
loss  based  on  a  life  expectancy,  of 
$212,248.00  in  earning  capacity,  and 
a  cost  to  the  state  of  Massachusetts 
of  $39,312.00.  According  to  the  cen- 
sus of  1910  there  were  180,000  insane 
persons  in  the  United  States.  Esti- 
mating 12  per  cent,  of  the  insanity  to 
be  due  to  syphilis  and  the  experience 
of  Massachusetts  to  be  applicable  to 
the  country  as  a  whole,  the  economic 
loss  in  earning  capacity  and  cost  of 
care  on  the  score  of  a  single  item  in 
the  total  bill  of  only  one  of  the  genital 
infections,  would  approximate  $467,- 
000,000.*  If  insanity,  a  relatively 
uncommon  complication  of  syphilis, 
can  alone  cost  more  than  a  half  bil- 
lion dollars,  the  cost  of  idleness  and 
death  from  other  and  equally  grave 
complications,  such  as  heart  and  kid- 

*It  is  to  be  noted  that  this  estimate  includes 
the  loss  of  life  expectancy. 


RESULTS  OF  PROSTITUTION  56 

ney  disease,  blindness,  deafness, 
paralysis  due  to  nervous  change, 
when  added  together,  will  total  fig- 
ures that  take  rank  beside  the  stu- 
pendous costs  of  war.  These  are  esti- 
mates of  the  cost  of  consequences.  The 
wastage  of  money  spent  on  ineffective 
treatment,  on  the  maintenance  of  hos- 
pitals and  dispensaries,  on  medical 
fees,  and  through  reduction  of  effi- 
ciency without  absolute  crippling  and 
death,  is  beyond  the  reach  of  compre- 
hension. 

" one-half  the  blindness  dating 

from  birth,  due  to  gonorrhea  of  the 
eye,  conveys  no  impression  whatever 
of  the  tragedy.  One  has  to  see  one 
of  these  little  children  rocking  back 
and  forth  in  a  railed-in  chair,  waving 
its  hand  between  face  and  window 
because  the  flickering  of  the  finger 
shadows  across  the  twilight  is  all  it 
will  ever  know  of  more  than  half  of 


56  VICE  AND  HEALTH 

life;  one  has  to  see  this  thing  and 
watch  the  baby  groping  about  on  the 
floor  and  gurgling  as  it  feels  of  your 
shoe  strings,  really  to  know  in  the  soul 
of  him  what  gonorrhea  means. 

"  Getting  at  the  matter  indirectly, 
figures  drawn  from  recent  army  expe- 
rience indicate  that  gonorrhea  is  3  or 
4  times  as  prevalent  as  syphilis. 

"  The  percentage  of  gonorrhea  in 
women  varies  largely  with  their  social 
status.  Among  the  most  refined  types 
of  unmarried  women  and  girls  it  is 
probably  negligibly  small.  Of  the 
pregnant  women  in  the  public  hos- 
pitals of  a  number  of  Continental 
cities,  20  to  25  per  cent,  were  said  to 
have  had  gonorrhea.  Prostitutes, 
professional  or  occasional,  nearly  all 
have  it.  The  estimated  prevalence  of 
the  disease  in  these  types  ranges  from 
70  to  95  per  cent.,  as  determined  by 
various  vice  investigations,  and  by 
studies  of  delinquent  women,  such  as 


RESULTS  OF  PROSTITUTION  57 

that  of  Haines,  who  found  percent- 
ages ranging  from  75.7  to  98.2  in 
500  cases. 

" enough  women  are  wrecked 

by  gonorrhea  in  one  way  or  another 
to  maintain  an  entire  specialty  in 
medicine — gynecology,  which  would 
become  relatively  a  side  issue  in  sur- 
gery if  the  effects  of  gonorrheal  pel- 
vic inflammation  and  of  abortion 
or  miscarriage  could  be  eliminated. 
Few  have  been  found  to  dispute  the 
opinion  of  Noeggerath,  who  first 
recognized  gonorrhea  in  women  as  a 
definite  and  distinct  condition  when 
he  stated  that  80  to  90  per  cent,  of  pel- 
vic inflammatory  disease  and  50  per 
cent,  of  absolute  and  one-child  steril- 
ity in  women  is  due  to  gonorrhea. ' ' 

Though  accidental  infection  must 
of  course  be  considered  in  computa- 
tions of  this  character,  the  fact  as 
already  stated,  that  80  to  90  per  cent. 


58  VICE  AND  HEALTH 

of  syphilis  is  by  way  of  direct  geni- 
tal transmission — gonorrhea  higher — 
fortifies  the  logic  in  attributing  the 
bulk  of  these  diseases  and  their  per- 
sistence directly  or  indirectly  to 
prostitution. 

Despite  the  fact  that  prostitutes 
are  the  dregs  and  outcasts  of  society, 
and  as  such  are  scorned  by  the  gener- 
ality of  women,  men  unhappily  are 
not  disposed  to  assume  the  same  an- 
tagonistic attitude  toward  them.  In 
this  matter,  therefore,  the  mistress  of 
the  mansion  and  the  sister  of  the  vice 
district  are  more  closely  related  than 
the  former  ever  imagines.  It  is  very 
well  and  most  proper  to  argue  single 
standard,  continence  and  the  like,  but 
young  men  (speaking  in  averages) 
have  so  far  not  been  particularly  sus- 
ceptible to  these  suggestions,  and  con- 
sequently invade  vice  districts  or  seek 
prostitution  in  Jts  other  forms. 


RESULTS  OF  PROSTITUTION  59 

While  it  is  not  to  be  concluded  that 
all  men  are  immoral,  the  fact  to  be 
emphasized  is,  that  so  long  as  the 
prostitute  is  a  readily  accessible  ele- 
ment in  society,  the  nation's  youth  is 
quite  likely  in  large  numbers  to  wend 
its  way  to  her  and  thus  wound  them- 
selves and  others. 

Parenthetically,  a  vast  amount  of 
suffering  and  even  death  can  be  elimi- 
nated if  parents  of  daughters  will 
insist  that  prospective  husbands  pre- 
sent authentic  evidence  of  good  physi- 
cal condition ;  this  should  include  not 
only  an  examination  for  gonorrhea 
but  a  laboratory  test  for  syphilis 
as  well. 

In  a  vice  raid  which  caught  in  its 
net  a  number  of  young  boys  from  a 
small  town,  it  was  freely  admitted 
that  excitement  and  adventure  were 
the  compelling  forces  of  the  lure — the 
sexual  act  a  post  incident  merely.  It 


60  VICE  AND  HEALTH 

was  a  group  idea  for  a  good  time  con- 
ceived and  executed  spontaneously. 
Sex  impulses  on  the  other  hand  are  by 
their  nature  individual.  As  a  matter 
of  fact,  a  large  proportion  of  the 
males  who  patronize  vice  resorts  are 
not  driven  there  by  any  overwhelm- 
ing sex  desire.  The  excitants  of  the 
old  time  "  line ",  such  as  music, 
liquor  and  negligee,  prove  the  neces- 
sity of  stimulation  to  produce  indis- 
criminate sex  activity.  It  is  fair  to 
assume,  therefore,  that  with  the  allur- 
ing possibility  removed,  the  physi- 
ological enthusiasm  in  a  large  num- 
ber of  cases  would  be  suppressed. 
The  argument  applies  equally  to  the 
quieter  accessible  forms  of  vice. 

Something  must  be  done  to  counter- 
act these  influences.  The  attack  has 
already  begun.  The  enemy  is  even 
now  forced  to  fight,  but  specialists 
cannot  do  it  all ;  generals  we  certainly 


RESULTS  OF  PROSTITUTION  61 

must  have,  but  the  common  soldier 
must  do  the  actual  hand-to-hand  work. 
To  better  understand  the  present  of- 
fensive and  the  necessity  of  individual 
community  interest,  a  brief  history  of 
the  government's  attack  upon  vener- 
eal diseases  follows. 


CHAPTER  V 

THE  GOVERNMENT'S  FIGHT 

When  the  White  Slave  Act  became 
law  in  1910,  a  vigorous  attempt  was 
made  to  enforce  it;  this  was  insti- 
gated by  the  Department  of  Justice 
and  supervised  by  its  Bureau  of  In- 
vestigation. 

Under  the  direct  leadership  of  S. 
W.  Finch,  local  officers  were  appoint- 
ed in  all  of  the  important  centers  of 
population  throughout  the  country. 
The  duty  of  such  agents  resolved 
itself  into  a  general  intimidation  of 
the  underworld  by  keeping  a  direct 
supervision  over  the  movements  of 
the  known  prostitutes.  It  must  be 
recalled  that  as  late  as  1914  many  of 
the  cities  in  the  United  States  had 

well-defined  vice  districts,  the  deni- 
es 


THE  GOVERNMENT'S  FIGHT  63 

zens  of  which  were  known  to  the 
respective  police  departments. 

As  the  United  States  had  no  au- 
thority to  dictate  local  policies,  the 
situation,  so  far  as  vice  neighbor- 
hoods were  concerned,  was  frankly 
recognized  as  part  of  the  process  to 
eliminate  inter-state  traffic  in  women ; 
this  being  the  purpose  of  the  Mann 
Act.  A  list  of  known  madams  and 
inmates  was  compiled  from  police 
data  which  was  supplemented  by 
direct  governmental  investigation ; 
and  by  forceful  suggestion  with  the 
sanction  of  the  city  authorities,  the 
heads  of  the  houses  were  required  to 
notify  the  government  officer  of  the 
arrival  or  departure  of  inmates,  on 
cards  prepared  for  the  purpose.  In 
this  manner,  a  constant  state  of  fear 
was  inculcated  among  the  women  and 
their  male  partners,  as  unexpected 
visits  were  made  by  the  special  agents 


04  VICE  AND.HEALTH 

to  resorts  to  check  up  reports ;  and  at 
these  times  the  consequences  of  vio- 
lating the  state  law  were  emphasized. 

While  this  procedure  was  in  force, 
a  large  amount  of  repression  was 
effected,  and  a  measure  of  education 
brought  home  to  likely  offenders. 
Valuable  facts  were  also  obtained 
during  this  activity,  so  that  when  it 
later  became  necessary  through  mili- 
tary emergency  for  the  federal  gov- 
ernment to  again  approach  the  sub- 
ject, a  strong  weapon  in  the  form  of 
information  was  at  hand  for  immedi- 
ate application. 

From  the  above  it  is  noted  that, 
prior  to  the  war,  organized  vice  so  far 
as  Washington  was  concerned,  was 
attacked  mainly  from  a  legal  and 
inter-state  standpoint 

While  American  troops  were  on 
the  Mexican  border,  the  Secretary  of 
War  ordered  investigators  to  Texas 


THE  GOVERNMENT'S  FIGHT  65 

for  first-hand  vice  facts,  which  re- 
sulted in  conclusively  demonstrating 
that  restricted  districts  near  large 
groups  of  soldiers  were  a  decided 
health  menace  to  the  military  popu- 
lation, and  that  the  fine  phrase  of 
"  medical  control  "  was  but  a  myth. 
From  this  the  Government  deduced 
that,  having  proved  futile  so  far  as 
the  Service  was  concerned,  this  fact 
held  with  equal  force  when  applied  to 
civilian  communities. 

Therefore,  when  the  European  war 
involved  the  United  States,  the  Secre- 
tary of  War  was  in  possession  of 
incontrovertible  and  impressive  facts. 
With  wise  forethought,  in  a  letter 
dated  May  26th,  1917,  he  wrote  the 
Governors  of  states  and  the  Council 
of  National  Defense  as  follows : 

"We  cannot  allow  these  young 
men,  most  of  whom  will  have  been 
drafted  to  service,  to  be  surrounded 

5 


M  VICE  AND  HEALTH 

by  a  vicious  and  demoralizing  envi- 
ronment, nor  can  we  leave  anything 
undone  which  will  protect  them  from 
unhealthy  influences  and  crude  forms 
of  temptation.  Not  only  have  we  an 
inescapable  responsibility  in  this  mat- 
ter to  the  families  and  communi- 
ties from  which  these  young  men  are 
selected,  but,  from  the  standpoint  of 
our  duty  and  our  determination  to 
create  an  efficient  army,  we  are  bound 
as  a  military  necessity,  to  do  every- 
thing in  our  power  to  promote  the 
health  and  conserve  the  vitality  of  the 
men  in  the  training  camps." 

The  Navy  Department  also  took  a 
firm  stand  in  the  matter,  all  of  which 
caused  a  solid  front  to  develop,  in- 
volving the  Army  and  Navy,  the 
United  States  Public  Health  Service, 
the  State  Boards  of  Health,  the  Coun- 
cil of  National  Defense  and  the  Com- 
mission on  Training  Camp  Activities, 


THE  GOVERNMENT'S  FIGHT  67 

in  an  effort  to  rid  the  camps  of  their 
surrounding  vice-infected  areas. 

It  was,  however,  very  soon  dis- 
covered that  the  communities  beyond 
camp  influence  were  necessary  ele- 
ments of  concern.  Segregated  and 
scattered  prostitution  had  to  be  sup- 
pressed wherever  possible,  irrespec- 
tive of  the  geographic  factor.  The 
burden,  in  large  measure,  fell  upon 
the  law-enforcement  representatives 
of  the  Commission  on  Training  Camp 
Activities,  the  personnel  of  which 
included  officers  of  the  Army  and 
Navy,  as  well  as  civilians,  whose  expe- 
rience fitted  them  for  their  work; 
these  men  operated  in  close  co-opera- 
tion with  the  medical  and  police  offi- 
cers of  both  branches  of  the  military 
service  and  also  with  the  United 
States  Public  Health  Service  rep- 
resentatives inside  and  outside  of  the 
camps. 


68  VICE  AND  HEALTH 

State,  county  and  municipal  au- 
thorities were  thus  awakened  to  the 
vital  importance  of  the  subject  and 
to  the  necessity  of  generating  a  maxi- 
mum of  efficiency  in  vice  suppression 
through  the  duly  and  legally  consti- 
tuted agencies.  Even  with  the  war 
emergency  this  was  no  easy  task. 
The  apathy  of  police  in  such  matters 
is  proverbial,  and  in  many  instances 
energetic  education,  coupled  with 
diplomatic  threats,  was  necessary  to 
obtain  results.  Moreover,  numerous 
city  organizations  and  their  repre- 
sentatives had  looked  upon  the  class 
against  which  the  offensive  was  di- 
rected as  an  asset,  and  selfishly  real- 
ized that  their  sanction  to  a  vigorous 
uprooting  of  the  evil  would  probably 
cause  the  loss  of  their  own  politi- 
cal prestige. 

In  this  connection,  it  is  recalled 
that  a  quarantine  covering  a  period 


THE  GOVERNMENT'S  FIGHT  69 

of  six  weeks  was  placed  upon  one  of 
the  large  cities  of  the  country  which 
effectively  restrained  the  soldiers  of 
the  nearby  cantonment  (at  that  time 
numbering  over  fifty  thousand)  from 
entering  it;  and  incidentally,  during 
the  same  period  quite  as  effectually 
educated  the  predominating  political 
influences  that  the  United  States  gov- 
ernment was  serious  and  meant  busi- 
ness. An  unusual  interest  in  social 
hygiene  and  law  enforcement  sud- 
denly developed  which  is,  to  that 
city's  credit,  still  heartily  sustained. 
In  some  cities,  before  elections,  a 
public  expression  of  candidates  on 
the  vice  question  was  compelled  (the 
Government  not  visibly  appearing  in 
the  compulsion  however)  and  thus  an 
issue  of  opposing  factions  made. 
When  this  situation  arose,  the 
"  clean "  candidates  were  usually,  if 
not  invariably,  elected. 


70  VICE  AND  HEALTH 

Ordinances  attacking  the  taxicab 
menace,  infringement  of  national  pro- 
hibition, and  dance  hall  mismanage- 
ment, together  with  sundry  health 
measures  were  under  the  stress  of 
emergency  and  the  spirit  of  patri- 
otism, successfully  passed  through  the 
city  councils  and  often  conscienti- 
ously enforced. 

Allied  to  the  fight  against  the  pros- 
titute who,  with  the  abolishment  of 
the  districts,  attemped  to  ply  her 
trade  clandestinely,  was  a  direct 
attack  upon  low  grade  apartment 
houses  and  hotels.  In  some  instances 
it  became  regrettably  necessary  to 
assume  a  belligerent  attitude  toward 
even  the  first  class  hostelries. 

Occasionally  a  demonstration  of 
conditions  became  essential  and  this 
was  accomplished  by  quiet  investiga- 
tions with  the  results  placed  before 
officials  and  others  directly  inter- 


THE  GOVERNMENT'S  FIGHT  71 

ested.  The  military  police  efficiently 
assisted  in  making  raids  and  obtain- 
ing data  upon  which  demonstrations 
were  predicated. 

Qualified  women  lecturers  reached 
the  various  groups  of  young  women 
in  many  cities  close  to  camps,  and 
thus  made  available  authentic  infor- 
mation upon  the  consequences  of  sex 
delinquency.  Their  activity  un- 
doubtedly possessed  a  marked  pre- 
ventive power. 

While  the  extra-cantonment  re- 
pressive activities  were  in  force,  much 
was  being  done  within  the  camps 
themselves.  The  work  in  this  in- 
stance rested  upon  the  shoulders  of 
the  medical  men,  including  United 
States  Public  Health  Service  per- 
sonnel attached  to  the  various  com- 
mands. Inasmuch  as  a  sick  soldier 
was  a  decided  military  liability,  defi- 
nite steps  were  taken  to  eradicate  dis- 
ease among  the  men.  The  venereal 


72  VICE  AND  HEALTH 

patients  were  isolated  or  semi-quar- 
antined, and  through  rational  treat- 
ment restored  to  health;  but  the  of- 
fensive did  not  stop  with  that. 

The  medical  departments  of  the 
Army  and  Navy  established  prophy- 
laxis stations  in  the  camps  and  in  the 
cities  frequented  by  service  men. 
Possibly  this  open  recognition  of  a 
fundamental  fact  of  nature  did  more 
to  keep  the  Army  and  Navy  clean 
than  any  other  measure.  Under  this 
system  every  man  in  the  service  who 
subjected  himself  to  exposure,  was 
ordered  to  present  himself  at  a  sta- 
tion for  treatment  within  four  hours ; 
failing  in  this  and  subsequently  found 
to  be  infected,  he  was  punished.  To 
some  men  this  necessity,  unattractive 
to  say  the  least,  was  in  itself  sufficient 
to  deter  natural  inclinations;  and 
if  otherwise,  made  the  chances  for 
unfortunate  complications  compara- 


THE  GOVERNMENT'S  FIGHT  78 

tively    remote    provided    treatment 
was  promptly  taken. 

Furthermore,  the  Public  Health 
Service  and  the  Red  Cross  established 
clinics  and  made  hospital  beds  avail- 
able for  the  purpose  of  treating  com- 
munity venereal  disease.  The  wisdom 
of  this  procedure  becomes  evident 
upon  the  authoritative  statement  that 
"  Over  five-sixths  of  the  venereal  dis- 
ease treated  in  America  up  to  the 
time  of  the  armistice,  was  acquired 
before  the  boys  put  on  the  uni- 
form."* In  this  regard  it  is  also 
interesting  to  note  that  "The  inci- 
dence of  venereal  disease  actually 
contracted  in  the  United  States  after 
entering  into  the  army  was  about 
forty-five  per  thousand  per  year  (less 
than  half  the  rate  obtaining  for  the 
five  years  preceding  the  war."t 

*  Major  Sawyer  in  "Today's  World  Problem 
in  Disease  Prevention  " — Stokes. 

t  Col.  Ashburn  in  Social  Hygiene,  January, 
1921. 


74  VICE  AND  HEALTH 

Through  the  United  States  Public 
Health  Service,  the  Training  Camp 
Commission,  and  kindred  lay  organi- 
zations, such  as  The  American  Social 
Hygiene  Association,  placards  and 
pamphlets  of  a  sex-educational  char- 
acter were  made  available  to  the  men. 
Compulsory  lectures  on  hygiene, 
reaching  the  entire  personnel,  were 
periodically  delivered  by  the  medical 
officers  at  the  camp,  and  these  were 
frequently  illustrated  by  moving  pic- 
tures and  slides.  Physical  examin- 
ations were  regular  and  searching.  In 
addition,  a  constructive  program  of 
wholesome  recreation  was  substituted 
by  the  government  for  the  former 
allurements  of  vice.  This  took  the 
form  of  athletics  and  amusements 
both  within  the  camp  and  without, 
and  the  establishment  of  social  cen- 
ters such  as  Soldiers  and  Sailors 
Clubs,  T.  M.  C.  A.  and  K  of  C.  huts, 
Jewish  Welfare  Boards,  and  Ameri- 


THE  GOVERNMENT'S  FIGHT  75 

can  Library  Association  buildings ;  so 
that,  in  reality,  the  enlisted  men  came 
under  a  more  rigid  paternalistic  in- 
fluence while  in  the  service  than  that 
to  which,  in  most  cases,  they  were 
accustomed  in  private  life. 

The  sum  total  of  these  various 
activities  was  that  Pershing's  Army, 
and  the  million  awaiting  absorption 
in  it  at  the  time  of  the  armistice,  was 
the  cleanest  group  of  men  in  the 
entire  world. 

With  the  conclusion  of  the  war, 
however,  the  Government's  interest 
in  the  problem  of  prostitution  and 
kindred  subjects  did  not  cease;  nor 
could  it  have  logically  assumed 
such  an  attitude.  Hostilities  happily 
coming  to  an  end  before  the  Govern- 
ment's fight  against  the  venereal  dis- 
ease situation  could  be  developed  to 
its  maximum,  many  conditions  still 
obtained  which  made  immediate,  con- 


7«  VICE  AND  HEALTH 

scientious  and  continued  effort  im- 
perative. A  failure  to  recognize  this 
fact  would  have  been  but  an  admis- 
sion of  national  indifference. 

With  the  signing  of  the  armistice 
certain  reactions  were,  and  even  yet, 
are  noted.  And  vice,  along  with 
other  matters,  such  as  industrial  un- 
certainty and  crime  in  general,  has 
been  affected.  The  idea  still  appears 
to  be  prevalent  "that  war  being  over 
there  is  no  reason  to  keep  the  lid  on." 
Upon  this  theory  various  municipali- 
ties relaxed  their  law  enforcement 
programs  and  clinical  facilities  de- 
veloped during  the  war,  and  govern- 
mentally  subsidized  clinics,  in  part,  if 
not  entirely,  went  out  of  existence 
through  the  lack  of  local  support. 
The  professional  woman  and  her 
intermediaries  became  bold,  and  in 
numerous  instances  districts  were  re- 
opened. 


THE  GOVERNMENT'S  FIGHT  77 

With  a  view  to  continuing  repres- 
sive measures  and  assisting  in  pre- 
ventive and  educational  activities,  the 
Interdepartmental  Social  Hygiene 
Board  was  created  by  Congress,  July, 
1918.  This  bureau  inherited  the 
duties,  among  others,  formerly  exer- 
cised by  the  Law  Enforcement  and 
Social  Welfare  Departments  of  the 
Commission  on  Training  Camp  Ac- 
tivities; and  fortunately  retained  a 
large  part  of  the  latter 's  personnel — 
trained  and  efficient  professional 
men  and  women.  Where  state  health 
bureaus  signified  their  desires,  and 
where  in  addition,  the  state  itself  had 
evidenced  a  proper  attitude  toward 
social  hygiene,  representatives  of  the 
board  were  assigned  to  them;  such 
agents'  activities  being  directly  under 
the  control  of  the  state  health  offi- 
cer. In  the  states  where  interest 
had  not  been  sufficiently  aroused, 


78  VICE  AND  HEALTH 

representatives  worked  out  of  and 
under  the  direction  of  headquarters 
in  Washington. 

Incidentally,  it  may  be  stated,  that 
a  Congressional  appropriation  known 
as  the  Chamberlain-Kahn  fund,  liber- 
ated money  from  the  federal  treas- 
ury for  state  social  hygiene  purposes 
on  a  pro  rata  basis  as  to  population  ; 
only  in  those  cases,  however,  where 
the  state  itself  appropriated  or  ob- 
tained a  part  or  whole  of  a  similar 
amount.  The  fund  in  addition  pro- 
vided for  hygiene  instruction  in  insti- 
tutions of  learning;  for  scientific 
medical  research  in  colleges  and  uni- 
versities; and  "  for  the  assistance  of 
states  in  the  care  of  civilian  persons 
— for  the  protection  of  the  military 
and  naval  forces  of  the  United  States 
against  venereal  diseases  ". 

Peace  duties  of  the  Board's  per- 
sonnel, included  the  direction  of  all 


THE  GOVERNMENT'S  FIGHT  79 

activity  looking  to  greater  efficiency 
in  law  enforcement,  a  campaign  of 
education  personally  applied  for  per- 
suasive and  constructive  purposes, 
and  the  drafting  and  engineering  of 
state,  county,  and  municipal  legisla- 
tion, which  from  time  to  time  was 
found  necessary.  The  women  agents 
of  the  Board  made  social  studies  of 
the  problems  involved  in  cases  of 
seventeen  thousand  delinquent  girls, 
thus  providing  valuable  statistical 
material  for  demonstration  through- 
out the  nation. 

Working  in  the  closest  kind  of 
association  with  the  IT.  S.  Public 
Health  Service  and  state  departments 
of  health  it  was  possible  for  this 
Board  to  assist  in  aiding  the  medical 
program  directly  by  arousing  public 
opinion  to  the  necessity  of  clinics, 
quarantine  hospitals,  education  for 
all  classes  of  people,  and  to  help  ob- 


80  VICE  AND  HEALTH 

tain  funds  for  such  purposes ;  the  end 
in  view  being  to  make  the  state,  or 
smaller  units  (counties,  cities,  bor- 
oughs) practically  autonomous  so  far 
as  finances  for  a  continued  fight 
against  venereal  diseases  are  con- 
cerned. Congress  recently 1  reap- 
propriated  $225,000  for  the  continu- 
ance of  the  Board's  field  work.  A 
separate  division  under  the  direction 
of  Assistant  Surgeon  General  C.  C. 
Pierce,  was  created2  in  the  U.  S. 
Public  Health  Service  for  the  official 
administration  of  its  venereal  dis- 
ease policies.  The  following  figures 
taken  from  "Two  Years  Fighting 
Venereal  Disease  3  will  indicate 
to  some  extent  the  excellent  co-opera- 
tive work  accomplished  by  the  Public 
Health  Service  and  the  state  boards 
of  health:  

1  June,  1921. 

*By  authority  of  the  Chamberlain-Kahn  Act. 
•Pamphlet  issued  by  the  U.  S.  Public  Health 
Service. 


THE  GOVERNMENT'S  FIGHT  81 

427  clinics  have  been  established. 

185,200  clinic  patients  have  been 
given  2,103,900  treatments. 

Nearly  60  per  cent,  of  the  druggists 
of  the  country  have  voluntarily  agreed 
to  stop  the  sale  of  quack  remedies  for 
self  treatment  of  venereal  diseases. 

19,800  newspapers  and  magazines 
have  agreed  to  take  out  or  keep  out 
advertisements  of  quack  doctors  and 
medical  institutions  treating  "  pri- 
vate diseases  of  men  ". 

150,000  placards  for  the  purpose  of 
attracting  persons  to  clinics  and  for 
education,  have  been  posted. 

60,700  physicians  have  pledged 
co-operation. 

740,000  young  men  and  boys  have 
seen  the  "  Keeping  Pit  "  exhibit. 

Thousands  of  high  schools,  Y.  M. 
C.  A.'s,  and  industries  have  co-oper- 
ated in  showing  exhibits. 


82  VICE  AND  HEALTH 

Exhibits  and  lantern  slides  have 
been  shown  to  13,000  audiences. 

Motion  pictures  have  been  shown  to 
3,600  audiences. 

5000  industrial  establishments  have 
undertaken  venereal  disease  work. 

More  than  20,500  lectures  have 
been  given. 

31  conferences  of  educators  have 
been  held. 

An  appropriation  by  Congress  of 
$200,000.00  was  made  to  continue  this 
work.*  Until  the  various  states 
(which,  after  all,  means  the  people  in 
them)  are  sufficiently  interested  to 
carry  this  national  problem  them- 
selves, governmental  aid,  at  least 
in  advice  and  personnel  assistance, 
if  not  in  money,  will  doubtless  be 
continued. 

*  February,  1921, 


CHAPTER  VI 

MEDICAL  MEASURES 

There  are  two  vital  medical  fac- 
tors to  be  considered  in  attacking 
venereal  disease.  The  first,  because 
of  its  emergency,  is  the  treatment  of 
existent  cases ;  the  second,  by  far  the 
more  fundamental  one,  is  the  removal 
of  the  sources  of  infection.  Only  the 
former  will  be  discussed  in  the  pres- 
ent chapter. 

Free  clinics  should  be  an  integral 
feature  of  community  sanitation. 
The  institution,  as  such,  may  take 
various  forms.  Clinics,  financed  en- 
tirely by  the  state  government  and 
operated  by  its  medical  and  nursing 
personnel,  have  been  found  to  be 
extremely  effective;  these,  however, 
should  function  only  sufficiently  long 

83 


84  VICE  AND  HEALTH 

to  demonstrate  their  need,  when  they 
should  be  taken  over  locally. 

Clinics  are  most  logically  estab- 
lished in  hospitals;  such  a  location 
removes  undue  advertisement  of  the 
patient's  motive  for  the  visit,  reduces 
overhead  to  a  minimum,  and  makes 
a  pay  clinic  possible  through  a  legiti- 
mate diversion  of  those  who  can 
afford  a  small  fee.  The  income  de- 
rived from  this  source  should  neutral- 
ize the  outlay  for  the  free  operation 
and  should,  indeed,  show  a  profit. 

Many  hospitals  depend  in  part 
upon  the  city,  county  or  state  for 
financial  support.  At  least  one  in 
every  municipality,  and  more  than 
one  in  the  larger  places,  should  there- 
fore be  persuaded  to  organize  clinics. 
If  necessary,  appropriations  should 
be  made  contingent  upon  such  action. 
Further,  no  general  hospital  receiv- 
ing public  funds  should  be  permitted 


MEDICAL  MEASURES  M 

to  exclude  venereal  patients  for  there 
is  no  valid  excuse  for  this  attitude 
unless  it  be  the  one  of  over-crowded 
conditions;  even  so,  unfair  discrimi- 
nation against  treating  gonorrhea 
and  syphilis  is  unjustifiable.  It  may 
be  stated,  however,  that  the  building 
programs,  projected  and  consum- 
mated, of  many  institutions  are  pro- 
viding ample  space  for  the  care  and 
treatment  of  venereal  diseases. 

A  trained  woman  social  worker 
should  be  attached  to  each  clinic  as 
part  of  the  regular  personnel.  Her 
work  should  include  the  financial 
classification  of  the  patients  (to  pre- 
vent the  public's  pauperization),  the 
determination  of  the  "  public-health- 
menace  "  feature  of  the  case,  and 
the  application  of  rehabilitative 
measures  upon  the  delinquent  fe- 
male or  a  proper  delegation  to  a 
recognized  agency. 


86  VICE  AND  HEALTH 

In  rural  and  sparsely  settled  com- 
munities clinical  facilities  may  very 
properly  be  substituted  by  the  choice 
of  a  capable  and  responsible  physi- 
cian to  represent  the  state,  drugs  and 
treatment  apparatus  to  be  supplied 
free ;  and  when  necessary,  state-subsi- 
dized post-graduate  work,  looking  to 
a  proper  professional  qualification, 
should  be  afforded  the  appointee. 
Country  people  unable  to  pay  can,  in 
this  way,  also  have  the  advantage  of 
efficient  service.  This  plan,  or  modi- 
fications of  it,  has  been  successfully 
employed  in  several  states. 

A  fair  proportion  of  the  patients 
will,  in  the  first  instance,  seek  per- 
sonal medical  advice ;  the  ethical  spe- 
cialists being  the  more  likely  men  to 
be  approached;  and  a  minimum  fee 
agreed  upon  by  them  (which  should 
be  the  maximum  of  the  pay  clinic) 
will  work  reciprocally  to  the  advan- 


MEDICAL  MEASURES  87 

tage  of  the  treatment  units — private 
practitioner,  the  pay  and  free  clinics. 

All  public  institutions  in  the  state 
should  require  of  inmates  examina- 
tion for,  and  the  treatment  of,  exist- 
ing venereal  disease;  penal  institu- 
tions especially  should  emphasize  this 
work  as  much  infection  can  thus  be 
detected  and  treated. 

One  of  the  greatest  obstructions  to 
effective  curative  measures  has  been 
the  advertising  quack  whose  sole  ob- 
ject is  to  bankrupt  his  victim,  usually 
accomplished  by  long  and  inadequate 
treatment.  Millions  of  dollars  an- 
nually are  in  this  manner  contributed 
by  gullible  victims.  There  is  no 
excuse  for  the  existence  of  quackery, 
and  laws  to  prevent  it  if  not  already 
enacted  should  be  passed  and  rigidly 
enforced.  In  lieu  of  sufficient  legis- 
lation, or  its  evasion  by  carefully 
worded  notices,  newspapers  carrying 


88  VICE  AND  HEALTH 

such  advertising  should  be  persuaded 
to  refuse  it;  if  unsuccessful,  pres- 
sure inspired  by  a  local  hygiene  com- 
mittee or  others  interested  is  quite 
justified.  Some  years  ago  this 
method  was  successfully  employed 
upon  one  editor,  manifesting  itself  in 
the  form  of  an  inspired  threat  by  two 
large  department  stores  to  discon- 
tinue the  use  of  his  paper  as  an  adver- 
tising medium  if  quack  matter  were 
carried.  The  business  office  immedi- 
ately saw  the  light  and  the  false 
promises  of  "  restored  manhood  >: 
and  "ten  days'  sure  cures"  became 
newspaper  history.* 

Self -treatment  through  the  medium 
of  "  cures  "  sold  over  a  drug  store 
counter  should  also  be  legislated  out 
of  existence ;  most  of  them  are  value- 
less, and  if  not,  require  technic  in  ad- 
ministration quite  beyond  the  ability 
or  experience  of  the  laity.  The  false 

*  Portland,  Ore. 


MEDICAL  MEASURES  89 

idea  of  "  secret  cure  "  has  already 
taken  a  tremendous  toll ;  it  has  been 
authoritatively  stated  that  "  a  large 
proportion  of  the  venereal  infections 
of  wives  and  children  are  to  be  traced 
back  to  the  use  of  some  nostrum  pur- 
chased at  a  drug  store".* 

The  physician,  whether  in  his  pri- 
vate office  or  on  the  staff  of  the  pay 
or  free  clinic,  must  be  concerned  not 
only  with  the  treatment  of  the  indi- 
vidual patient  but  should  make  every 
effort  to  locate  the  probable  source 
of  infection.  Equally  important  is 
the  systematic  follow-up  of  the  neg- 
lectful patient.  The  social  worker, 
connected  with  the  clinic,  working  in 
co-operation  with  a  properly  educated 
health  officer  and  deputies,  and  cer- 
tain members  of  the  police  force, 
should  be  able  to  adequately  handle 
this  phase  of  the  problem. 

*  Medical  Measures,  a  pamphlet  published  by 
The  American  Social  Hygiene  Association. 


90  VICE  AND  HEALTH 

Pre-natal  and  post-natal  clinics, 
from  the  standpoint  of  prevention, 
are  of  inestimable  service.  These 
become  child  welfare  centers,  which 
not  only  have  a  vast  effect  in  conserv- 
ing the  life  and  health  of  children, 
mothers  and  families  generally,  but 
produce  a  definite  reduction  of  syphi- 
lis and  blindness  in  children;  they 
also  carry  with  them  a  powerful  edu- 
cational appeal. 

The  necessity  for  this  service  is 
more  readily  appreciated  when  it  is 
realized  that  "  syphilis  affects  the 
race  by  destroying  outright  seventy- 
five  per  cent,  of  the  children  of  syphi- 
litic parents  before  they  are  born,  or 
during  the  first  year  of  life,  and  by 
crippling  or  weakening  a  consider- 
able portion  of  those  who  survive  ".* 
In  response  to  an  inquiry  made  at  a 
large  institution  for  blind  childrent 

•"Today's    World   Problem   in   Disease   Pre- 

vention" — Stokes. 
tOverbrook,  Pa. 


MEDICAL  MEASURES  01 

the  following  telegram  was  received: 

"  Of  239  pupils  enrolled,  fiscal  year 
ended  May  31,  1920,  79  were  blind 
from  ophthalmia  neonatorum.  Our 
ophthalmologist  estimates  that  sixty 
per  cent,  of  these  are  gonorrheal 

infections "  Such  facts  speak 

for  themselves. 

A  report  from  Thavies  Inn,  a  treat- 
ment center  of  London  for  venereally 
infected  pregnant  women,  states: 

" . . .  .Every  child  born  during  the 
past  year  and  treated  at  the  center 
was  free  from  any  syphilitic  mani- 
festations    If  systematic  inten- 
sive measures  could  be  applied  to 
every  mother  who  has  syphilis,  while 
she  is  carrying  a  child,  we  should  wit- 
ness an  immediate  and  surprising 
decrease  in  the  transmission  of  infec- 
tion to  off-spring. 

"  So  effective  is  this  treatment  of 
the  mother  before  the  birth  of  her 


92  VICE  AND  HEALTH 

child  that  it  is  the  duty  of  every  phy- 
sician called  upon  to  deal  with  preg- 
nant women  to  be  familiar  with  the 
essentials  of  syphilology  and  to  secure 
for  those  under  his  care  proper  expert 
investigation  and  treatment  if  find- 
ings show  the  presence  of  disease." 

There  can  be  no  question  as  to  the 
value  of  reporting  venereal  diseases ; 
especially  is  this  procedure  necessary 
upon  a  neglect  of  treatment  or  remov- 
al from  the  jurisdiction.  Physicians 
and  the  public  must  be  educated  to 
this  idea,  either  by  the  logic  of  such 
a  regulation  or  by  the  painful  experi- 
ence of  penalties  imposed  for  the  fail- 
ure to  carry  out  its  purport.  Whether 
the  report  should  be  by  name  or  num- 
ber still  remains  to  be  determined. 
It  is  quite  necessary,  however,  that 
the  quacks  be  first  out  of  the  way; 
otherwise  for  very  apparent  reasons, 
a  large  portion  of  the  business  (to  the 


MEDICAL  MEASURES  93 

patient's  and  the  public's  detriment) 
will  fall  into  their  hands.  Funda- 
mentally, the  success  of  such  a  meas- 
ure depends  upon  an  enlightened  pub- 
lic and  professional  opinion,  and  this 
feature  should  be  most  vigorously 
pressed.  The  profession  must  be 
made  to  realize  that  a  disease  caused 
by  moral  dereliction  has  no  higher 
standing  than  maladies  innocently 
acquired,  and  that  an  equal  obliga- 
tion exists  to  protect  the  public 
from  infection. 

The  question  01  personal  prophy- 
laxis, as  found  in  the  sale  of  early 
treatment  packages  or  administra- 
tions at  a  public  clinic,  appropriately 
comes  under  a  discussion  of  medical 
measures.  This  form  of  prevention, 
if  applied  early  and  properly,  is  like- 
ly to  kill  the  germs  which  develop 
syphilis  and  gonorrhea.  Those  fav- 
oring this  preventive  measure  state 


04  VICE  AND  HEALTH 

their    argument    somewhat   in   this 

fashion : 

Beady  accessibility  to  such 
treatment  is  not  likely  to  in- 
crease immorality  by  inspir- 
ing a  feeling  of  security.  The 
real  incentive  to  sex  activity 
is  the  primal  biologic  law  for 
the  propagation  of  the  spe- 
cies. Skirts  to  the  knees, 
jazz  dancing,  bare-legged 
musical  revues,  and  the  abso- 
lute freedom  of  the  sexes  in 
daily  life  may  perhaps  be 
considered  as  some  of  the 
more  immediate  excitant  in- 
fluences, if  indeed  any  are 
required;  but  to  give  credit 
to  prophylaxis  for  popu- 
larizing extra-marital  inter- 
course is  much  easier  claimed 
than  proved.  The  real  con- 
cern, therefore,  does  not  ap- 


MEDICAL  MEASURES  95 

pear  to  rest  so  much  upon 
morals  as  upon  the  possible 
medical  results  to  be  obtain- 
ed from  such  a  procedure. 
For  more  than  a  year  one  of  the 
largest  states  *  after  laboratory  tests 
made  by  it,  has  marked  an  approval 
of  certain  "  immediate-treatment ': 
packages.    The  value  of  this  plan  lies 
not  merely  in  such  an  approval  and 
the   consequent   distribution   of  the 
article   to   the  various   drug   stores 
but  in  its  use  by  the  ultimate  con- 
sumer. But  despite  legitimate  adver- 
tisement upon  the  platform,  by  mov- 
ing picture   slides   and   commercial 
posters,  the  rush  for  this  commodity 
by  the  youth  of  the  state,  which  was 
prophesied  by  over-sensitive  alarm- 
ists, has  not  materialized. 

The  British  Government  has  offi- 
cially placed  itself  on  record  as 
follows : 

*  Pennsylvania. 


VICE  AND  HEALTH 

"  The  question  which  con- 
fronts the  British  Govern- 
ment is  that  there  is  no  un- 
animity of  opinion  on  the 
medical  side  as  to  the  prac- 
ticability of  self -disinfection 
for  the  civilian  population, 
whereas  on  the  moral  and 
social  side  most  weighty  ob- 
jections are  advanced  against 
it.  This  question  is  one  in 
which  the  moral  and  social 
considerations  as  well  as  the 
medical,  are  important.  In 
the  circumstances  the  Brit- 
ish Government  has  decided 
that  it  cannot  give  official 
support  to  self-disinfection 
as  a  policy.  The  Ministry 
of  Health  is  of  the  opinion, 
however,  that  the  arguments 
which  have  influenced  the 
British  Government  in  de- 


MEDICAL  MEASURES  97 

tiding  against  this  measure, 
do  not  apply  to  the  provision 
of  ablution  centers.  Final 
conclusions  as  to  the  value  of 
such  centers  cannot  be 
drawn,  but  experience  thus 
far,  warrants  the  continu- 
ance of  the  experiment."* 


*  Statement  of  policy  filed  under  date  of  May 
31st,  1921.  Note— The  U.  S.  Public  Health  Ser- 
vice, the  U.  S.  Interdepartmental  Social  Hygiene 
Board,  and  the  American  Social  Hygiene  Asso- 
ciation have  not  officially  expressed  themselves 
upon  this  point;  however,  the  question  still 
to  be  a  moot  one  in  the  United  States. 
7 


CHAPTER  VII 

LAW  ENFORCEMENT 

Every  locality  possesses  its  duly 
constituted  officials,  as  well  as  agen- 
cies, for  the  enforcement  of  law. 
Cities  especially  have  complex  and 
ample  machinery  for  this  purpose; 
boroughs  are  less  fortunate. 

The  police  departments  of  first, 
second  and  third  class  municipalities 
are  usually  sufficient  in  personnel  to 
maintain  law,  order  and  decency; 
though  more  frequently  than  other- 
wise where  vice  is  concerned,  inspi- 
ration is  somewhat  lacking.  Heads 
of  departments  are  sometimes  con- 
trolled figureheads,  whose  capabili- 
ties are  measured  not  by  their  pro- 
fessional ability  and  experience,  but 
rather  by  the  number  of  votes  that 

08 


LAW  ENFORCEMENT  99 

they  can  command.  The  force  itself 
is  fertile  ground  for  a  spoils  system, 
despite  so-called  civil  service.  How- 
ever, it  is  gratifying  to  note  that  a 
number  of  cities  realize  the  wisdom 
of  an  efficient  police  department. 

It  has  been  estimated  that  in  one 
of  the  largest  American  cities  *  ten 
thousand  follow  crime  as  a  profes- 
sion, practising  it  with  all  of  the  skill 
and  system  of  modern  business.  It 
was  also  calculated  that  this  crime 
trust's  annual  profits  exceeded  twelve 
million  dollars.  This  is  alarming,  if 
true.  It  certainly  indicates  that  vice 
and  crime  in  very  large  communities 
are  not  the  outcome  of  individual  and 
scattered  effort,  but  are  centralized 
activities  with  master  minds  in  con- 
trol. Smaller  localities  reflect  the 
same  conditions.  Therefore,  if  mu- 
nicipal security  is  desired,  a  system- 

*  Chicago,  HI. 


100  VICE  AND  HEALTH 

atic  and  efficient  fight  must  be  made, 
and  due  compensation  allowed  for  it. 
Recently,  an  eastern  city,*  over-run 
with  vicious  elements,  obtained  the 
services  of  a  then  captain;  of  state 
police.  Politics  and  tradition  were 
thrown  aside  and  the  new  head  of  the 
department  was  given  carte  blanche. 
A  strict  disciplinarian,  this  profes- 
sional officer  has  obtained  most  satis- 
factory results.  While  the  effort  was 
by  no  means  limited  to  the  successful 
suppression  of  prostitution,  neverthe- 
less under  his  direction  and  tutelage 
the  proverbial  sympathy  of  the  po- 
liceman toward  the  prostitute  was 
promptly  dissipated. 
^In  passing,  it  may  be  mentioned 
that  the  average  guardian  of  the  law 
has  been  made  to  feel  by  those  com- 
mercially interested,  that  the  removal 
of  vice  is  an  encroachment  upon  the 

*  Wilkes  Barre,  Pa. 


LAW  ENFORCEMENT  J01 

personal  liberties  of  the  male  popu- 
lation, and  that  facilities  for  the  pro- 
miscuous exercise  of  the  sex  instinct 
are  very  practically  embodied  in 
places  of  assignation.  Protection 
money,  more  common  than  generally 
supposed,  paid  to  certain  policemen, 
strategically  stationed,  has  also 
served  to  maintain  false  attitudes  of 
leniency.  Experience  has  proved, 
however,  that  a  half  hour's  lecture 
given  to  the  force  by  a  health  expert 
supplemented  by  an  unmistakable 
attitude  by  the  chief  himself,  not  only 
officially  but  personally  impresses  the 
patrolmen  with  the  advisability  of 
obeying  orders.  After  all,  policemen 
are  reasonable  human  beings,  and 
when  made  acquainted  with  the  plain 
facts  of  venereal  disease  in  its  rela- 
tion to  prostitution,  are  apt  to  de- 
velop a  satisfactory  viewpoint. 

However,  a  police  department,  even 


102  VICE  AND  HEALTH 

if  effectively  functioning,  is  but  the 
first  phase  in  the  legal  process. 
Though  the  detection  of  crime  and  the 
arresting  of  criminals  is  properly 
delegated  to  that  arm  of  the  law,  the 
disposition  of  the  case  rests  with  the 
judicial  branch.  Difficulties  are  here 
confronted.  Under  existing  legisla- 
tion, evidence  of  a  most  direct  char- 
acter is  usually  required  to  hold  pros- 
titutes and  other  sex  offenders  for  a 
trial  by  jury,  and  indeed,  even  within 
those  jurisdictions  where  the  laws  are 
of  sufficient  strength,  magistrates  are 
too  prone  to  accept  a  charge  of  dis- 
orderly conduct  and  thus  summarily 
dispose  of  the  case  by  the  imposition 
of  a  fine,  rather  than  to  bind  over  for 
court.  Then,  too,  if  the  case  does 
reach  the  jury,  verdicts  in  favor  of  the 
defendants  and  against  the  weight  of 
the  evidence  are  likely  to  ensue. 
The"  fine  " system ia utterly inade- 


LAW  ENFORCEMENT  103 

quate  as  a  deterrent.  If  prostitutes 
realized  that,  whether  a  health  menace 
or  not,  they  could  be  put  to  work  for 
sixty  or  ninety  days,  or  detained  in  an 
institution  for  an  indefinite  period 
under  penal  regulations;  and  if  the 
men  involved  in  this  insidious  busi- 
ness were  equally  aware  that  their 
activities  would,  if  detected,  send 
them  to  the  penitentiary  for  a  term 
of  years,  less  enthusiastic  activity 
would  be  the  direct  result. 

It  is  readily  understood  that  jail 
sentences  may  in  some  instances  work 
a  hardship,  especially  toward  young 
women  new  to  the  business;  but 
sympathy  should  not  outride  the  vital 
importance  of  results  or  the  principle 
of  the  greatest  good  to  the  greatest 
number.  Young  girls  will  hesitate  to 
lead  a  prostitute's  life  when  they 
realize  that  being  caught  involves 
more  than  reaching  into  their  purse 


104  VICE  AND  HEALTH 

and  producing  a  small  fine  and  costs ; 
the  procurer  will  become  more  chary 
when  he  discovers  that  an  attempt  to 
make  a  fee  out  of  some  girl's  shame 
means  the  closing  of  prison  doors 
upon  him. 

A  crooked  or  narrow-visioned 
magistrate  can  thus  quite  easily  upset 
the  conscientious  effort  of  a  police 
department.  It  is  here  that  enlight- 
ened officials  become  essential.  Theo- 
retically, the  mayor  is  the  inspiration 
back  of  the  police  policy  in  the  average 
community,  and  he  reflects  the  atti- 
tude of  the  group  of  politicians 
responsible  for  his  election.  A  police 
department  dominated  by  a  red-light 
mayor  means  wide  open  vice — until 
the  public,  urged  by  reformers,  rebels. 
Even  then  a  removal  or  two  from  the 
force,  a  notice  to  the  underworld  to 
keep  under  cover,  or  a  conference 
called  by  the  chief  executive  to  which 


LAW  ENFORCEMENT  105 

prominent  citizens  are  asked  for  the 
purpose  of  hearing  selected  speakers 
deliver  addresses  on  the  community's 
purity,  are  the  general  results  and 
usually  represent  the  sum  total  of 
consequences. 

Thus  it  is  observed  that  local  politi- 
cal and  official  antagonism  to  the 
enforcement  of  law  represents  a  prob- 
lem most  difficult  of  solution.  Where 
the  question  is  one  merely  of  unen- 
lightenment,  the  obstacles  are  not  so 
hard  to  overcome.  But  in  either 
event,  the  successful  handling  of  the 
problems  comprehends  the  modern 
definition  of  law  enforcement  activity. 

Such  service  calls  for  a  highly 
specialized  and  qualified  representa- 
tive, whose  activities  must  essentially 
be  inspiring  in  character. 

Officials,  and  not  the  law  enforce- 
ment representatives,  enforce  the 
law;  therefore  if  the  desired  ends  are 


106  VICE  AND  HEALTH 

to  be  obtained  a  careful  study  of 
the  administration  personnel  of 
any  given  city  should  be  made.  Such 
a  survey,  properly  conducted,  will 
determine  which  officials  are  wrong 
and  those  whose  sympathies  may  be 
counted  upon  for  help.  State  health 
departments,  therefore,  should  have 
upon  their  payrolls  an  individual 
thoroughly  competent  to  perform 
these  duties,  operating  under  the 
direction  of,  or  in  connection  with, 
the  division  for  venereal  control. 

After  a  preliminary  survey  of  the 
views  of  the  officials  is  completed, 
authoritative  facts  of  the  conditions 
must  also  be  in  the  representative's 
hands  before  he  can  suggest  a  change 
either  directly  to  the  administration 
or  through  accredited  sources.  The 
vice  inspector  thus  becomes  essential. 

The  term  "  police  detective  ",  ex- 
cept in  large  cities,  is  a  misnomer. 


LAW  ENFORCEMENT  107 

City  plain-clothes  men  are  merely  dis- 
guised officers  and  the  vice  elements 
know  them  better  than  they  do  the 
average  blue-coat;  to  employ  their 
services,  even  if  obtainable,  would  be 
for  many  reasons  plainly  absurd.  The 
same  is  true  of  local  detective  agen- 
cies; not  so,  however,  with  the  state 
police.  With  nothing  but  their  effi- 
ciency records  at  stake,  two  or  three 
trained  agents  from  such  a  force  will 
in  a  week's  time  gather  legal  evidence 
against  the  vice  system  of  a  city,  in- 
cluding prostitution,  gambling  and 
associated  crimes.  Lacking  such  a 
possible  source  from  which  to  draw, 
the  national  agencies  may  be  called 
upon  for  assistance  in  securing  infor- 
mation, or  the  state  health  depart- 
ments may  have  operatives  for  this 
purpose  attached  directly  to  their 
organizations. 
The  practical  advantage  of  such 


108  VICE  AND  HEALTH 

service  is  readily  understood  by  the 
following  illustration:  A  city  of  two 
hundred  thousand  population  showed 
a  high  venereal  rate.  The  clinician 
at  the  state  dispensary  found  unmis- 
takable evidences  of  red-light  opera- 
tions. State  police  were  called  in  and 
in  five  days  obtained  the  facts.  The 
mayor,  with  a  leaning  toward  segre- 
gation, inspired  by  a  very  commercial 
city  health  physician,  was  approached 
by  the  state's  law  enforcement  repre- 
sentative, who  was  informed  that 
vice  had  been  eradicated  a  year  be- 
fore. Sworn  affidavits  of  a  recent  date 
were  then  offered  in  refutation.  The 
Commissioner  of  Public  Safety  was 
likewise  advised;  he,  in  turn,  de- 
manded the  presence  of  the  police 
chief,  who  sent  for  his  captain,  and 
finally  the  patrolmen  on  the  beat 
involved  were  brought  in  and  officially 
reprimanded.  While  the  side-play 


LAW  ENFORCEMENT  109 

was  unimpressive  and  the  attempts  to 
shift  responsibility  almost  ludicrous, 
the  net  result  nevertheless  was  the 
suppressing  of  the  district  and  an  in- 
creased attention  given  to  clandestine 
vice.  Usually,  however,  the  issue  is 
not  so  clean  cut  nor  the  results  quite 
so  speedily  obtained.  It,  therefore, 
becomes  necessary  to  educate  local 
organizations  as  to  the  need  of  im- 
provement, to  form  committees,  and 
even  resort  to  publicity  measures  in 
an  effort  to  develop  sufficient  oppo- 
sition to  existing  vice  conditions.  It 
should  be  readily  understood  that  the 
law  enforcement  representative  is 
likely  to  secure  better  results  by 
remaining  discreetly  in  the  back- 
ground in  this  offensive.  If  he  func- 
tions to  standard  he  will  so  instill  in 
the  local  groups  and  individuals  the 
principles  for  which  he  stands,  that 
after  making  his  evidence  and  argu- 


110  VICE  AND  HEALTH 

ments  available  to  these  persons  he 
can  assume  second  place ;  in  fact,  drop 
comparatively  out  of  sight.  His 
power  should  be  felt  rather  than  per- 
sonally demonstrated. 

Though  local  units,  of  course,  must 
be  given  attention,  the  state,  in  terms 
of  the  general  population,  must  also 
be  his  concern.  Inadequate  penal  and 
health  laws  must  be  supplemented  by 
advanced  legislation,  and  state  offi- 
cials must  be  persuaded  to  assist  in  its 
enactment.  General  policies  for  the 
establishment  of  clinics,  detention 
hospitals,  educational  and  rehabilita- 
tive measures  should  be  within  his 
jurisdiction,  and  their  adoption  suc- 
cessfully negotiated. 

Unquestionably  from  a  health 
standpoint,  clandestine  vice  presents 
the  most  difficult  problem  for  law 
enforcement  solution.  Disseminated 
and  clandestine  prostitution,  as 


LAW  ENFORCEMENT  111 

already  noted,  take  the  following 
general  forms :  Hotel  and  apartment 
house  activity,  rooming-houses,  auto- 
mobile services,  dance  halls,  skating 
rinks,  and  other  places  of  public  con- 
gregation. To  appreciate  the  diffi- 
culties likely  to  be  encountered  it 
becomes  necessary  to  consider  these 
questions  in  detail. 

As  previously  mentioned,  the  com- 
plex life  found  in  the  larger  hostelries 
proves  a  substantial  obstruction  to  a 
successful  attack.  Moreover,  the 
standardization  of  dress  on  the  part 
of  women  and  the  general  use  of  cos- 
metics have  made  it  almost  impossible 
to  distinguish  the  lady  of  refinement 
from  her  sister  of  easy  virtue;  per- 
sonalities therefore  cannot  be  safely 
indulged  in  by  the  clerks  unless  sus- 
picion is  well  grounded.  And  im- 
moral persons  can  with  little  difficulty, 
assuming  they  present  an  appearance 


112  VICE  AND  HEALTH 

of  respectability,  obtain  accommoda- 
tion. If  the  prostitute  discovers  a 
too  inquisitive  attitude  on  the  part  of 
the  desk  man  (which  in  rare  instances 
occurs),  she  calls  to  her  assistance  the 
obliging  taxicab  driver  who,  posing  as 
her  husband,  registers  for  himself  and 
for  her  as  man  and  wife  at  another 
hotel,  takes  his  fee,  and  leaves  the 
woman  free  to  work  the  place.  The 
more  general  practice,  however,  is 
to  be  accompanied  by  her  cadet  who 
"plants"  her  and  acts  as  procurer 
and  cashier.  Strict  supervision  upon 
each  floor  by  competent  house  detec- 
tives is  capable  of  reducing  the  possi- 
bilities in  this  regard;  though  up  to 
the  present  time  a  majority  of  the 
managements  have  had  little  concern 
as  to  the  conduct  of  their  guests  so 
long  as  quiet  and  order  prevail.  Here 
again  the  question  of  education  be- 
comes a  vital  factor. 


LAW  ENFORCEMENT  113 

Experience  has  demonstrated  that 
the  average  hotel  manager  or  owner 
is  amenable  to  constructive  criticism ; 
conferences  called  at  the  request  of 
the  local  Association  including  its 
representatives,  and  addressed  by  law 
enforcement  and  health  officials,  very 
often  have  a  most  salutary  effect. 
Once  more,  authoritative  facts  based 
upon  evidence,  will  afford  the  most 
impressive  method  of  presentation. 

While  the  better  type  of  apartment 
house  is  less  likely  to  be  invaded  by 
the  prostitute  than  are  the  others, 
many  women  of  questionable  charac- 
ter have  been  accepted  by  rent  agents 
and  have  landed  safely  in  these  estab- 
lishments. The  eyes  and  ears  of  neigh- 
bors, however,  are  quick  to  detect 
irregularities,  and  unless  operating 
very  quietly  the  immoral  woman  is 
soon  made  aware  that  she  has  selected 
an  uncomfortable  site  for  her  activi- 

8 


114  VICE  AND  HEALTH 

ties.  On  the  other  hand,  lower  grade 
places,  with  little  or  no  ownership 
supervision,  coupled  with  the  general 
indifference  of  the  other  inmates,  ful- 
fill a  demand  comparatively  safe  for 
operation.  A  strict  watch  kept  upon 
such  houses  by  capable  city  police,  or 
other  secret  service  men,  and  the 
obtaining  of  direct  evidence,  will 
remove  the  worst  features;  this  fail- 
ing, the  abatement  law  now  in  force 
in  a  number  of  states,  which  provides 
for  the  closing  of  such  resorts  under 
a  restraining  order  from  the  court, 
may  be  invoked. 

The  misnamed  "  rooming-house  " 
is  difficult  to  undermine.  As  a  "blind" 
several  men  may  be  lodging  there,  as 
well  as  women ;  the  business  is  ostensi- 
bly conducted  by  the  inmates  upon  a 
personal  basis  rather  than  under  the 
direction  of  the  proprietress  herself. 


LAW  ENFORCEMENT  115 

To  combat  the  situation  direct  evi- 
dence is  necessary. 

The  element  of  salesmanship  is  a 
more  important  problem  to  the  prosti- 
tute than  ever  before ;  in  this  respect 
she  is  now  deprived  of  the  advantages 
of  beer  gardens,  cheap  dance  halls 
with  liquor  facilities,  and  of ttimes  of 
open  street  solicitation.  Theatres, 
fairs,  and  large  public  gatherings  are 
still  left  to  her  but  are  not  permanent 
opportunities,  and  at  best  are  precari- 
ous. This  predicament  creates  an 
increased  demand  for  the  man  solici- 
tor, known  in  the  vernacular  as  the 
"  pimp  ".  To  meet  this  necessity, 
bell-boys,  taxicab  drivers  and  even 
night  clerks  readily  fall  into  line. 
Internal  sanitation  of  a  large  or  small 
hostelry  therefore,  to  be  worth  while, 
must  involve  the  utmost  scrutiny  of 
the  conduct  of  its  personnel. 

Taxicab  chauffeurs  present  a  very 


116  VICE  AND  HEALTH 

difficult  problem;  and  this  may  be 
properly  considered  with  the  third 
phase  of  the  question,  namely,  that  of 
the  automobile  itself. 

Though  statistics  are  not  available, 
the  assertion  is  ventured  that  at  this 
time  there  is  not  a  less  responsible 
class  of  men  in  the  country  than  the 
auto-for-hire  chauffeur.  Lazy  and 
frequently  vicious,  many  of  these  fel- 
lows are  in  direct  touch  with  the 
underworld  and  have  contacts  with 
the  tangible  and  intangible  forms  of 
vice.  An  effective  method  of  control 
is  in  the  passage  and  enforcement  of 
regulative  ordinances.  Such  a  law 
should  provide  for  the  answering  of 
questionnaires  as  to  age,  residence, 
prior  occupation  and  references; 
and  a  license  should  only  be  issued 
when  the  police  department  is  thor- 
oughly satisfied  as  to  the  appli- 
cant's reliability. 


LAW  ENFORCEMENT  117 

While  the  lower  type  dance  halls 
largely  went  out  of  existence  with  the 
passage  of  the  Volstead  Act,  there  are 
yet  many  places  where  dances  are 
conducted  with  assignation  oppor- 
tunities. Of  this  type  the  "  closed  " 
dance  hall  is  the  most  offensive.  A 
"  closed  "  resort  is  one  wherein  the 
feminine  contingent  is  limited  to  per- 
sonnel hired  by  the  management.  An 
institution  of  this  character  virtually 
predominates  as  an  assignation  cen- 
ter. Investigations  based  upon  per- 
sonal experience  led  unquestionably 
to  the  conclusion  that  women  who  are 
found  in  these  places  are  there  pri- 
marily for  the  purpose  of  prosti- 
tution. In  a  resort  of  this  kind  raided 
sometime  ago  *  the  disease  rate  was 
discovered  to  be  over  97  per  cent. ;  and 
the  women  operating  in  this  place, 
ranging  from  sixteen  to  thirty  years 
of  age,  had  been  assembled  from  vari- 

*  Outside  Tacoma,  Wash. 


118  VICE  AND  HEALTH 

ous  sections  of  another  state  where 
laws  against  prostitution  made  it 
uncomfortable  for  further  activi- 
ties there. 

Though  resorts  of  this  nature  are 
more  likely  to  be  found  in  the  west- 
ern section  of  America  than  in  the 
East,  its  close  competitor  is  the  ordi- 
nary public  dance  hall  with  no  real 
police  or  moral  check  upon  it.  Defi- 
nite supervision  in  charge  of  female 
probation  officers,  and  the  enforcing 
of  the  age  law,  are  valuable  to  a 
limited  extent. 

Both  skating  rinks  and  cabarets, 
especially  the  latter,  possess  assigna- 
tion possibilities  to  a  very  great  de- 
gree. However  intangible  this  situ- 
ation appears  to  be,  it  is  neverthe- 
less one,  which  with  earnest  effort, 
can  be  minimized;  such  an  effort 
should  include  a  tactful  policy  of 
police  intimidation. 


LAW  ENFORCEMENT  119 

With  proper  ordinances  passed 
and  enforced  to  eliminate  street  solici- 
tation, the  employment  of  investigat- 
ing personnel,  the  proper  patrolling 
and  lighting  of  parks,  and  due  punish- 
ment meted  out  to  the  convicted 
offender,  this  clandestine  aspect  of  the 
problem  can  be  considerably  reduced. 

There  must  not  be  any  confusion  as 
to  the  limitations  of  the  purpose  in- 
volved in  law  enforcement  activity. 
In  the  present  meaning  of  the  term, 
its  application  does  not  seek  to  control 
or  regulate  personal  morals.  Such 
matters  properly  come  within  the 
domain  of  others.  Often  in  practical 
experience  the  two  objects  have  been 
confused  with  most  damaging  results. 

A  strict  law  enforcement,  however, 
along  lines  indicated  above,  has 
already  demonstrated  itself  to  be  one 
of  the  most  powerful  methods  of  com- 
bating venereal  disease. 


CHAPTER  VIII 

MEDICO-LEGAL  MEASURES 

There  appears  to  be  a  very  definite 
feeling  among  those  having  first-hand 
information,  that  law  enforcement 
activities  alone,  which  deal  with  the 
courts  in  the  first  instance,  do  not  lead 
to  the  desired  results  as  effectually  as 
does  medical  procedure.  This  idea  is 
well  founded.  During  the  world  hos- 
tilities the  major  attack  was  waged 
against  the  segregated  vice  districts 
upon  the  theory  that  these  places 
represented  the  large  tangible  and 
removable  sources  of  venereal  infec- 
tion. But  as  time  went  on  and  care- 
ful investigations  were  made,  it  was 
appreciated  that  as  a  matter  of  health 

policy  the  closing  of  vice  districts  was 
120 


MEDICO-LEGAL  MEASURES  121 

but  the  beginning  of  the  program  for 
venereal  disease  control. 

Some  workers  today  labor  under 
the  misconception  that  a  vice  district 
includes  the  larger  share  of  market- 
able prostitution.  Consequently,  it  is 
not  surprising  that  in  many  communi- 
ties well  intentioned  and  interested 
people  are  enthusiastic  over  the  idea 
that  a  district  closed,  no  matter  how, 
means  vice  and  disease  removed.  This 
view,  however,  takes  little  account  of 
disseminated  and  clandestine  activity. 

The  ramifications  of  sex  iniquity 
have  already  been  explained  in  a 
former  chapter,  but  the  fact  must  not 
be  overlooked  that  individual  prosti- 
tution as  found  in  hotels,  assignation 
houses,  automobile  activities  and  the 
more  recent  road-house  developments, 
carry  with  them  as  large  a  disease  bur- 
den as  the  district  itself. 

While  vice  neighborhoods  must  be 


1£2  VICE  AND  HEALTH 

eliminated,  there  is  more  to  the  ques- 
tion than  the  mere  closing  of  these 
places.  A  large  percentage  of  the 
women  of  such  districts  being  in- 
fected, it  is  evident  that  without  medi- 
cal control  of  some  kind  over  them, 
disease  is  merely  spread.  Inspired 
by  a  reform  group  or  by  political 
expediency  a  mayor  may  order  his 
chief  of  police  to  abolish  the  district. 
What  follows? 

The  average  head  of  a  police 
department  already  has  the  names 
and  addresses  of  the  known  prosti- 
tutes upon  his  desk,  and  he  quietly 
issues  orders  to  the  underworld  to  go 
out  of  business.  Bags  are  packed  and 
the  inmates  leave  town  or  seek  other 
fields  of  operation  within  the  same 
community,  taking  their  disease  with 
them.  Madams  of  resorts  who  own 
their  places  assume  an  air  of  respect- 
ability and  live  more  or  less  pre- 


MEDICO-LEGAL  MEASURES  123 

cariously  until  official  vigilance  is 
again  dormant. 

It  should  at  once  be  appreciated 
that  a  score  of  red-light  districts  thus 
closed,  while  undoubtedly  affecting 
the  element  of  ready  marketability 
and  diminishing  to  a  certain  extent 
exposure  to  infection,  does  not  in  any 
real  way  lower  the  disease  incidence. 

It  is  true  that  new  legislation  has 
been  passed  in  a  number  of  states 
defining  prostitution  and  calling  for 
prison  sentences.  But  the  handicaps 
in  obtaining  legal  evidence  and  the 
general  attitude  of  leniency  by  jurors, 
will  make  the  advantages  of  this 
procedure  from  the  standpoint  of 
health  a  problematical  one,  unless 
medical  measures  are  contemporane- 
ously applied.  A  jury  box  containing 
female  representation  may  in  a  meas- 
ure overcome  the  latter  objection. 
Nevertheless  the  fact  remains  that  a 


124  VICE  AND  HEALTH 

tremendous  amount  of  education  must 
be  applied  to  enforce  drastic  laws  on 
prostitution.  A  report  recently  re- 
ceived from  a  large  city  having  most 
progressive  anti-vice  legislation,  elo- 
quently indicates  that  laws  and 
law  enforcement  are  not  always 
synonymous. 

After  all,  the  nation's  vital  interest 
in  vice,  at  least  at  the  present  time, 
centers  around  the  venereal  diseases 
and  their  consequences.  Most  prop- 
erly, therefore,  if  the  matter  can  be 
handled  from  this  point  of  view  it  is 
more  logical,  and  as  has  been  demon- 
strated, is  likely  to  be  more  effective. 

The  establishment  of  treatment  fa- 
cilities in  the  form  of  clinics,  even 
with  a  thorough  follow-up,  leads  no- 
where with  a  certain  class  of  patients. 
Young  men  have  been  observed  loiter- 
ing in  the  neighborhood  of  public 
clinics  for  the  sole  purpose  of  meet- 


MEDICO-LEGAL  MEASURES  125 

ing  women  when  they  leave,  appar- 
ently under  the  misguided  notion  that 
these  patients  have  been  rendered 
temporarily  innocuous. 

It  becomes  evident  that  different 
types  seek  medical  advice.  First, 
men  and  women  who  are  sincerely 
interested  in  their  own  recovery  and 
whose  conduct,  including  continence 
during  the  infectious  period,  does  not 
make  them  detrimental  to  the  public 
health ;  and  second,  those  who  by  their 
habits,  occupation  or  lack  of  it,  are 
health  menaces.  Police  cases  referred 
to  the  clinic,  prostitutes  and  procurers 
are  among  the  latter  class. 

The  laws,  both  punitive  and  medi- 
cal, are  not  unfair  in  their  discrimi- 
nation against  the  woman.  However, 
a  man  who  has  contracted  venereal 
disease,  unless  of  the  criminal  class  or 
sexually  debased,  is  likely  to  remain 
continent  during  the  inf  ectiousness  of 


126  VICE  AND  HEALTH 

his  malady.  Women,  to  him,  from  a 
sex  standpoint,  are  quite  unattractive, 
and  his  mood  is  one  of  extreme  con- 
cern for  his  physical  welfare  rather 
than  toward  licentiousness  or  promis- 
cuous sex  contact.  It  can,  therefore, 
be  fairly  assumed  that  the  "  respect- 
able "  man,  married  or  single,  who  by 
reason  of  a  moral  lapse  becomes  dis- 
eased, will  not  deliberately  and  with 
malice  aforethought  pass  on  his  infec- 
tion to  others.  It  is  quite  the  reverse 
however,  with  the  degraded  man  who 
has  no  regard  for  his  own  physical 
welfare  or  that  of  anybody  else. 
Unfortunately,  there  are  many  such. 

The  largest  number  of  the  "  health- 
menace  "  type  are  to  be  found  among 
the  prostitutes  whose  bread  and 
butter  depend  upon  general  sex  activi- 
ties. This  is  the  big  problem. 

The  absurdity  of  merely  treating 
persons  of  this  kind  is  clear.  It  would 


MEDICO-LEGAL  MEASURES  127 

be  just  as  sensible  for  a  physician  or 
hospital  to  prescribe  for  an  ambula- 
tory case  of  diphtheria  and  then  per- 
mit the  patient  to  mingle  freely  in  the 
community  until  the  next  visit,  as  to 
allow  a  public-health-menace  venereal 
case  to  transmit  the  disease  as  soon  as 
he  or  she  leaves  the  treatment  room. 
This  type  must  be  controlled  and  iso- 
lated during  the  infectious  period. 
Without  an  effective  quarantine  a 
vast  amount  of  preventable  damage 
is  done. 

In  the  very  nature  of  things,  the 
woman  who  prostitutes  herself  is 
more  than  likely  to  come  under  clini- 
cal observation  from  one  or  another 
source ;  and  quarantine  should  at  once 
apply  if  she  is  infectious.  In  raids 
conducted  by  police  or  medical  au- 
thorities, reasonable  discrimination, 
after  proper  investigation,  can  be 
made  against  the  inmate  in  favor  of 


128  VICE  AND  HEALTH 

the  casual  male  visitor.  If,  however, 
the  man  either  within  the  house  of 
prostitution  or  elsewhere,  is  a  police 
character  or  is  spreading  disease,  he 
too  should  be  quarantined. 

It  is  recalled  that  a  vice  district  in 
a  certain  city  was  successfully  in- 
vaded, and  those  found  there  were 
brought  to  the  police  station,  where 
the  legal  and  medical  quarantine  fea- 
tures simultaneously  functioned. 

The  representative  of  the  State 
Department  of  Health  put  a  blanket 
quarantine  upon  all  the  women,  pend- 
ing diagnosis;  but  after  physical 
examination  for  gonorrhea  he  per- 
mitted all  but  three  of  the  men  to 
leave  (bail  having  been  obtained  for 
the  criminal  charge)  upon  a  promise 
that  they  would  appear  at  the  clinic 
for  blood  tests.  This  procedure  was 
only  adopted  after  conferring  with 
the  police  and  confirming  statements 


MEDICO-LEGAL  MEASURES  129 

as  to  names  and  addresses.  All  of  the 
men  reported  at  the  clinic  and  the 
majority  were  found  to  be  free  from 
disease.  The  greater  number  of  the 
women,  however,  were  found  to  be 
infected,  and  quarantine  was  in  their 
case  continued. 

The  point  is,  that  the  male  fre- 
quenters in  this  instance  were  not  vi- 
cious but  indiscreet;  the  women  on 
the  other  hand  were  thoroughly  de- 
praved, and,  but  for  restraint,  would 
have  immediately  left  the  jurisdiction. 

It  may  be  mentioned,  incidentally, 
that  the  medical  officer  referred  to 
above,  was  two  days  later  informed 
that  the  manager  of  a  chain  store  com- 
pany was  being  promiscuous  while 
suffering  from  gonorrhea;  and  the 
s  report  being  confirmed  the  man  was 
apprehended  and  kept  under  absolute 
quarantine,  despite  the  efforts  of  his 
business  associates  to  secure  his  re- 

9 


180  VICE  AND  HEALTH 

lease.  From  a  practical  standpoint, 
therefore,  there  should  be  absolutely 
no  difference  of  attitude  or  of  treat- 
ment when  dealing  with  the  man  or 
woman  if  there  is  any  reason  to  sup- 
pose that  his  or  her  liberty  will  result 
in  a  further  spread  of  contagion. 

There  are  two  methods  of  imposing 
quarantine:  First,  to  placard  the 
home  of  the  patient;  second,  to  iso- 
late and  control  in  a  detention  hos- 
pital. The  majority  of  quarantinable 
venereals  are  naturally  incorrigible 
and  at  best  lead  nomadic  existences, 
therefore  immediately  upon  the  pla- 
carding of  the  house  the  card  is  torn 
down  and  the  person  under  quaran- 
tine leaves  town  to  pollute  other  fields. 
Without  the  establishment  of  guards 
at  the  front  and  back  doors  main- 
tained for  a  twenty-four  hour  pe- 
riod, this  type  of  restraint  is  unavail- 
ing. Detention  quarters  adequately 


MEDICO-LEGAL  MEASURES  131 

equipped  for  the  care,  treatment  and 
isolation  of  persons  who  are  public 
health  menaces  is  the  only  reason- 
able alternative. 

The  ideal  institution  is  a  separate 
hospital  operated  by  municipal  and 
county  funds,  constructed  for  the  pur- 
pose and  providing  wards  for  both 
men  and  women.  However,  in  lieu  of 
this  arrangement,  hospitals  receiving 
state  appropriations  should  be  per- 
suaded to  set  aside  wards  for  such 
patients,  if  possible.  Where  over- 
crowded conditions  will  not  permit 
such  a  disposition,  the  renting  or  pur- 
chasing and  operating  of  a  building 
supported  by  municipal  or  county 
finances,  is  a  very  proper  solution; 
lacking  such  possibilities,  county  jails 
and  almshouses  should  be  utilized  as 
a  temporary  expedient.  Prisons,  par- 
ticularly, due  to  prohibition,  now  have 
vacant  sections  frequently  equipped 


132  VICE  AND  HEALTH 

with  modern  conveniences,  quite 
adaptable  for  such  a  make-shift 
policy.  The  installation  of  clinical 
apparatus  is  a  minor  detail. 

The  practical  objections  to  this  last 
mentioned  plan  involve  first,  the  con- 
sent of  the  officials,  which  is  often 
hard  to  obtain;  and  second,  the  idea 
of  incarcerating  people  whose  menace 
is  limited  to  infection  with  a  com- 
municable disease.  However,  when  it 
is  realized  that  most  of  these  patients 
are  not  unfamiliar  with  the  penal  fea- 
tures of  a  jail,  based  upon  previous 
personal  experience  at  one  time  or 
another,  the  second  objection  becomes 
one  of  sentiment  rather  than  of  solid 
reason.  It  may  be  stated  that  a  grati- 
fying attitude  of  co-operation  by 
officials,  in  these  various  phases  of 
control  is  being  observed. 

The  establishment  of  a  centralized 
institution  or  a  group  of  institutions 


MEDICO-LEGAL  MEASURES  133 

within  the  state  and  under  its  direc- 
tion, operated  upon  a  financial  plan 
similar  to  hospitals  for  the  insane,  is 
already  receiving  consideration  by 
several  states.* 

Obviously,  as  a  preliminary  condi- 
tion to  the  above  outlined  ideas,  legis- 
lation, if  not  already  existing,  should 
be  enacted. 

The  benefits  of  quarantine  are  quite 
apparent.  The  possibility  of  the 
patient's  infecting  others  is  elimi- 
nated ;  and  with  the  prostitute  this  is 
an  exceedingly  large  factor.  Figur- 
ing on  five  exposures  a  day  and  two 
infections,  the  control  for  thirty  days 
of  one  hundred  patients  saves  six 
hundred  from  disease.  Again,  the 
possibility  of  reinfection  during  the 
treatment  period  is  also  removed. 

•The   state   of   Pennsylvania   has   a   400-bed 
hospital  for  the  treatment,  care  and  isolation  of 
volitional  and  public-health-«nenace  patients;   (the 
latter     admitted     under     quarantine^ — Act     of 
May,   1921.) 


184  VICE  AND  HEALTH 

Moreover,  with  proper  social  service, 
rehabilitative  measures  can  be  insti- 
tuted, and  with  some  chance  of  suc- 
cess where  the  young  offender  is  con- 
cerned. Then,  too,  medical  observa- 
tion can  be  undertaken,  and  the  psy- 
chiatrist can  with  care  seek  for  feeble 
mindedness,  and  after  cure  of  the 
venereal  disease  can  have  the  mental 
defectives  permanently  removed  from 
society.  And  finally,  quarantine  has 
a  deterrent  influence  upon  further 
harmful  activity  after  the  offender  is 
released.  Being  thus  detained  and 
liberty  taken  away,  the  patients  are 
made  to  appreciate  to  their  sorrow 
that  here  is  an  instance  where  the 
shyster  lawyer,  bail  and  even  habeas 
corpus  proceedings  are  absolutely 
impotent. 

Pennsylvania  perhaps  has  gone 
further  in  applying  quarantine  than 
any  other  state  in  the  Union.  By  law, 


MEDICO-LEGAL  MEASURES  135 

patients  may  be  quarantined  while 
diagnosis  is  being  confirmed,  upon  a 
reasonable  suspicion  that  a  com- 
municable disease  exists.*  A  prima 
facie  or  convicted  prostitute,  there- 
fore, is  reasonably  suspected  of  hav- 
ing venereal  disease,  based  upon  in- 
controvertible medical  statistics  that 
from  ninety-four  to  ninety-six  per 
cent,  of  her  kind  have  gonorrhea,  or 
syphilis,  or  both.  This  is  a  powerful 
weapon  and  its  effectiveness  has  been 
most  clearly  demonstrated. 

Pennsylvania  State  Police  have 
been  commissioned  health  officers  and 
as  such  obtain  evidence;  later  the 
prostitutes  are  apprehended  and 
quarantined  in  a  house  of  detention. 
This  is  accomplished  in  the  business- 
like and  efficient  manner  for  which 
this  organization  is  known  the  world 
over.  State  police  in  other  jurisdic- 

*  Act  of  April  16,  1921. 


186  VICE  AND  HEALTH 

tions  should  be  utilized  in  the  same 
way.  Lacking  these,  trusted  mem- 
bers of  the  local  police  forces,  with 
health  officer  authority,  could  thus 
function.  In  this  way  poor  law  en- 
forcement and  jury  leniency  can  be 
overcome  when  necessary.  On  the 
other  hand,  the  evidence  upon  which 
the  quarantine  is  predicated  is  usually 
of  court  quality;  and  the  agitation 
locally  aroused  by  the  medical  meas- 
ure will  demand  activity  in  the  crimi- 
nal courts,  at  which  time  the  state  po- 
lice can  testify  in  court  to  excel- 
lent advantage. 

But  whatever  the  particular  method 
may  be,  until  the  public-health-men- 
ace type  of  patient  is  not  only  treated 
but  detained  under  quarantine,  mere 
medication  is  a  travesty  and  the 
vicious  circle  of  disease  remains 
solidly  intact. 


CHAPTER  IX 

EDUCATION 

Education  is  considered  by  many  as 
the  only  practical  antagonist  to  vice 
and  disease.  Undoubtedly  personal 
education  in  sex  hygiene  will  be  of 
great  value,  but  the  perversity  of 
human  nature  is  so  strong  and  the  sex 
instinct  so  powerful,  that  an  academic 
fortification,  unless  surrounded  by 
assisting  barriers,  will  not  be  as  avail- 
ing as  might  at  first  be  supposed. 
However,  education  in  a  broader  mu- 
nicipal sense  (to  be  explained  in  a  suc- 
ceeding chapter)  applied  contempo- 
raneously with  personal  propaganda, 
will  come  closer  to  obtaining  desired 
results  than  any  other  form  of  attack. 

It  is  not  too  much  to  hope  that  the 
present  day  parent  can  be  effectually 

197 


138  VICE  AND  HEALTH 

and  generally  reached  by  education, 
though  difficulties  are  in  the  way. 
Home  life  as  an  institution  is  not  the 
compact  organization  it  formerly 
was;  too  frequently  it  represents  a 
comfortable  refuge  where  the  neces- 
sary creature  comforts  are  obtain- 
able, and  stops  there.  There  is  a 
reason  for  this.  The  modern  attitude 
toward  diversion  is  one  of  the  out- 
standing features  of  our  social  life. 
Today,  young  and  old  demand  a  crowd 
and  a  ticket  to  measure  up  to  their 
idea  of  fun ;  self -satisfying  pleasures 
are  passe.  Firesides,  in  consequence, 
are  forsaken  for  automobiles,  caba- 
rets, dances  and  theaters ;  and  normal 
family  life  loses  its  grip.  Parents, 
therefore,  must  be  taught  to  reaffirm 
their  natural  prerogatives  and  cease 
to  permit  young  daughters  and  sons 
to  become  imbued  with  the  false 
standards  of  life  so  frequently  ab- 


EDUCATION  139 

sorbed  at  the  motion  picture  house, 
dance  hall  and  the  all  too  common  joy- 
ride.  Belying  less  upon  the  virtue  of 
their  offspring  and  more  upon  ration- 
ally applied  discipline,  the  morals  and 
health  of  children  can  be  success- 
fully guarded. 

It  is  apparent  that  the  above  state- 
ment is  considerably  easier  to  make 
than  is  its  application ;  and  will  need 
in  addition  to  the  parents'  ambition, 
assistance  from  the  children  them- 
selves. It  is  right  here  that  opti- 
mism is  justified.  Self  control  taught 
in  childhood  can  be  relied  upon  to 
so  fortify  the  average  youth  that 
he  will  not  fall  an  easy  prey  to 
sex  temptations. 

The  adolescent,  too,  is  most  impres- 
sionable— amenable  and  retentive  to 
new  ideas  and  thoughts.  Teachers,  if 
qualified,  can  be  of  immeasurable 
assistance  in  instilling  moral  values 


140  VICE  AND  HEALTH 

in  their  students,  though  the  assump- 
tion is  unfortunately  general  that 
young  people  should  not  be  brought 
into  academic  contact  with  vice  lest  it 
corrupt  virgin  thought.  In  this  re- 
spect we  lose  sight  of  our  own  "  wis- 
dom "  acquired  in  devious  ways  dur- 
ing the  early  years.  It  is  safe  to  say 
that  nearly  every  young  girl  or  boy 
possesses  a  fund  of  misinformation 
upon  matters  of  which  they  are  sup- 
posedly ignorant.  Venereal  diseases 
among  school  children  of  grammar 
and  high  school  grades  are  painful 
evidence  of  this  fact. 

It  is  not  surprising  that  young  men 
are  ignorant  of  the  consequences  of 
promiscuous  sex  activity  when  but  a 
few  years  ago  the  medical  profession, 
except  for  a  comparatively  few  spe- 
cialists, was  unacquainted  with  their 
far  reaching  ravages.  Personal  con- 
tact with  prostitutes  was,  and  still  is, 


EDUCATION  141 

urged  by  some  as  one  of  the  necessi- 
ties to  experienced  young  manhood. 
And  among  many,  the  theory  of  im- 
munity with  the  clandestine  or  charity 
girl  still  obtains  with  great  force. 
These  false  conceptions  must  be 
eliminated. 

While,  generally  speaking,  it  is 
harder  to  control  virile  youths  than 
maidenhood  by  demonstrating  the  dis- 
ease pitfalls  incident  to  vice ;  properly 
inspired  fear  will  lead  to  preventive 
measures,  preventive  treatment  and 
even  continence.  Normal  schools 
could  accomplish  much  by  including 
instruction  in  social  hygiene.  Per- 
haps the  most  powerful  weapon 
against  illicit  sex  experience  is  to 
be  found  in  a  constructive  sex  edu- 
cation which  gives  to  the  boy  and 
girl  a  real  incentive  for  clean  living 
as  exemplified  in  a  happy  marriage 
and  healthy  children. 


142  VICE  AND  HEALTH 

Teachers  are  the  links  between 
parents  and  children,  and  as  such  can 
supply  deficiences  in  sex-education 
not  received  at  home.  Institutions  of 
higher  learning  should  have  compul- 
sory courses  in  physical,  mental  and 
emotional  hygiene,  preferably  given 
in  the  first  term  of  the  first  year. 
Many  first  sex  experiences  take  place 
during  this  trying  period,  when  with 
the  restraint  of  the  home  or  the  pre- 
paratory school  removed,  temptation 
is  strong  and  delinquency  becomes  a 
line  of  least  resistance.  Women's 
institutions,  moreover,  must  not  be 
overlooked  in  this  regard.  Too  often 
young  women  while  informed  upon 
many  subjects  are  deplorably  ignor- 
ant with  respect  to  their  own  bi- 
ologic and  physiologic  nature;  and 
this  lack  of  information  has  fre- 
quently created  conditions  leading  to 
unfortunate  results. 


EDUCATION  143 

In  any  educational  program,  group 
contacts  should  be  made ;  for  example, 
such  as  are  found  in  large  industrial 
plants,  factories,  stores,  Boy  Scouts, 
Girl  Scouts,  the  Y.  M.  C.  A.,  the  Y.  W. 
C.  A.  and  various  civic  organizations ; 
in  short,  the  entire  community  should 
be  systematically  covered.  How  is 
this  to  be  accomplished? 

Extreme  caution  must  be  applied  to 
the  technic  of  approach.  Tact  should 
be  the  controlling  factor  in  the  pre- 
sentation. While  no  definite  general 
rules  can  be  laid  down,  anything 
which  smacks  of  fanaticism  should  be 
studiously  avoided,  both  as  to  per- 
sonnel and  subject  matter.  To  be 
effective  the  subject  must  be  handled 
sanely  by  sane  people.  Over  or  mis- 
placed emphasis  may  kill  the  chances 
for  desired  results.  Reformers  should 
not  be  employed  for  publicity  pur- 
poses; on  the  other  hand,  business 


144  VICE  AND  HEALTH 

men  and  women  and  physicians  of 
both  sexes  command  and  obtain  re- 
spect. Lectures  should  be  standard- 
ized for  the  various  groups,  and  as  far 
as  possible  be  distributed  to  the  speak- 
ers from  a  central  office,  such  as  that 
of  a  state  health  department.  With 
the  youth  especially,  personal  rather 
than  sex  hygiene,  should  represent 
the  burden  of  the  message,  but  elo- 
quence and  emphasis  should  be  di- 
rected as  an  incident  to  the  latter. 
With  more  mature  audiences  subtlety 
may  be  dispensed  with  and  a  direct 
presentation  made. 

With  the  various  avenues  of  pub- 
licity accessible,  it  becomes  a  question 
of  logical  utilization  rather  than  of 
choice.  Any  and  all  of  the  propa- 
ganda channels  may  be  employed. 

The  motion  picture  as  a  medium  is 
unsurpassed,  reaching,  as  it  does, 
millions  of  people.  Most  state  boards 


EDUCATION  145 

of  health  possess  for  distribution 
movie  films  and  stereoptican  slides 
designed  to  impress  the  observer  with 
facts  which  should  deter  and  reduce 
promiscuous  vice.  Private  agencies, 
such  as  The  American  Social  Hygiene 
Association  of  New  York  City,  also 
make  similar  material  available. 
Commercial  picture  houses,  churches, 
schools,  industrial  plants,  all  should 
be  urged  to  display  such  exhibits.  It 
imust,  however,  not  be  overdone — too 
much  familiarity  in  the  form  of  repe- 
tition will  breed  indifference  and 
even  contempt. 

Short  articles  in  the  public  press 
are  most  advantageous,  but  the  ut- 
most care  should  be  taken  as  to  the 
presentation  of  the  subject.  State 
supervision  through  the  educational 
division,  or  officer,  of  its  health 
department,  is  most  desirable.  Own- 
ers and  editors  of  newspapers,  fre- 

10 


146  VICE  AND  HEALTH 

\ 


quently  uninformed  of  the  necessity 
of  publishing  such  features,  refuse 
them;  courteous  pressure  in  these 
cases  is  indicated  and  essential. 

The  distribution  of  approved 
pamphlets  prepared  for  the  main 
social  groups  will  familiarize  many 
with  the  disease  risks  of  promis- 
cuity and  thus  help  to  engender  a 
proper  feeling  against  the  various 
vice  manifestations. 

The  methods  of  presentation  above 
outlined  call  for  local  initiative. 
While  a  state  department  of  health 
may  be  reasonably  relied  upon  to  fur- 
nish a  measure  of  the  impetus,  it  can- 
not furnish  all  of  it.  If  education  is 
to  be  really  effective  the  inspiration 
involved  must  be  produced  from  the 
inside,  which  plainly  depends  upon 
community  interest.  A  state  cam- 
paign imposed  upon  a  locality,  by  its 
very  nature,  is  a  temporary  matter; 
and  in  this  phase  of  the  attack  as  well 


EDUCATION  147 

as  in  all  of  the  others,  perseverance 
and  persistence  alone  can  bring  last- 
ing results. 

With  misinformation  acquired  over 
a  long  term  of  years  as  the  result  of 
ignorance,  patience  must  be  exercised 
in  the  attitude  of  many  men  and 
women  upon  the  general  questions 
concerned.  When  it  is  discovered  that 
there  are  leading  business  men  and 
city  officials,  who,  despite  overwhelm- 
ing scientific  and  medical  evidence  to 
the  contrary,  still  believe  in  segre- 
gated vice  and  in  attempts  at  medical 
regulation,  one  cannot  be  too  hard 
upon  the  individual  official  and  the  av- 
erage man  who  treats  this  matter  with 
indifference. 

Conversion  will  come,  but  it  can- 
not be  attained  in  a  day  or  even  in 
a  year.  Patience  and  consistent  per- 
severance, however,  will  eventually 
reap  their  reward. 


CHAPTER  X 

WELFARE  AND  REHABILITATION 

The  development  of  social  work  has 
been  exceedingly  rapid  in  recent 
years.  Juvenile,  morals  and  domestic 
relations  tribunals,  as  well  as  organi- 
zations specifically  interested  in  these 
phases  of  community  and  individual 
welfare,  have  called  for  a  special 
group  of  trained  persons,  who,  as  the 
need  arose,  were  found.  Universities 
and  colleges  have  introduced  courses 
of  wide  range  into  their  curricula 
designed  to  qualify  men  and  women 
in  this  type  of  activity.  Applied 
philanthropy  and  social  service  may 
therefore  be  considered  as  a  pro- 
fession in  itself. 

No  community  is  properly  equipped 
to  handle  the  general  problem  of  vice 
in  its  relation  to  health,  unless  it  has 

148 


WELFARE  AND  REHABILITATION        140 

trained  sociological  personnel  con- 
nected in  some  manner  with  the  law 
enforcing  staff.  Where  special  courts 
do  not  exist  workers  should  be  at- 
tached to  the  police  department  or  the 
district  attorney's  office. 

As  intimated  in  a  previous  chapter, 
small  communities  are  limited  in  en- 
forcement personnel.  Too  often  the 
dignity  of  the  law  is  upheld  in  a  desul- 
tory fashion  by  an,  eighty-dollar-a- 
month  chief  of  police  and  two  or 
more  equally  underpaid  assistants. 
This  deficiency,  so  far  as  vice  is  con- 
cerned, can  in  some  measure  be  over- 
come by  an  efficient  welfare  worker. 

Every  community,  be  it  large  or 
small,  possesses  its  relatively  fixed 
number  of  delinquent  women  and 
girls;  and  in  addition  presents  a 
clearly  defined  pre-delinquent  prob- 
lem. The  specialized  case  worker  as  a 
detector  of  sex  dereliction  in  neighbor- 


150  VICE  AND  HEALTH 

hoods  of  limited  population  becomes 
therefore  a  highly  necessary  adjunct ; 
she  can  render  invaluable  assistance  in 
locating  the  known  characters  com- 
mercially inclined,  and  even  in  the 
face  of  police  indifference  can  direct 
to  clinics  those  found  to  be  in  need  of 
treatment.  Also,  when  required,  she 
can  initiate  and  complete  an  institu- 
tional disposition  of  the  case. 

The  value  of  such  work  should  at 
once  be  clear.  Venereal  diseases  in 
many  small  places  can  be  traced  to  a 
comparatively  few  delinquents  who 
usually  are  of  the  clandestine  or  semi- 
clandestine  variety.  This  results  in 
their  walking  the  streets,  engaging  in 
solicitation,  and  becoming  rather  well 
fixed  in  the  eyes  of  the  community. 
However,  with  a  cleverness  born  of 
necessity,  this  type  frequently  so  con- 
ducts herself  that  the  arm  of  the  law 
cannot,  or  does  not,  reach  out  for  her ; 


WELFARE  AND  REHABILITATION        151 

it  is  then  that  the  case  worker's  inter- 
est may  be  tactfully  applied.  She  is 
not  compelled  to  wait  until  the  of- 
fender has  been  arrested ;  and  the  lack 
of  court  evidence  need  not  embarrass 
her.  Inferences  drawn  from  appear- 
ances and  actions  are  all  of  the  evi- 
dence she  requires.  Her  official  stand- 
ing makes  the  approach  easy ;  and  her 
training  qualifies  her  for  a  tactful 
handling  of  the  situation,  A  dozen 
girls  removed  from  the  community 
and  an  additional  number  rendered 
non-infectious,  will  markedly  reduce 
the  incidence  of  venereal  disease  in 
small  places.  An  efficient  representa- 
tive should  be  able  to  accomplish  this 
within  a  short  time. 

In  cities  the  individual  interest  of 
the  social  worker  only  becomes  active 
after  a  diversion  of  a  case  by  the 
courts  or  by  a  welfare  group.  With 
the  reference  of  the  case  personal  his- 


152  VICE  AND  HEALTH 

tories  are  obtained,  mental  and  physi- 
cal tests  made,  and  the  conditions  pre- 
requisite to  proper  disposition  ascer- 
tained. A  personal  study  of  the  hard- 
ened prostitute  leads  to  the  conclusion 
that  as  a  class  rehabilitative  measures 
have  little,  if  any,  effect.  Feeble- 
mindedness, neurasthenia,  criminal 
tendencies  and  drug  addiction  indi- 
cate that  the  chances  are  decidedly 
against  any  real  headway  in  reform. 
Institutional  restraint  is  the  only 
reasonable  solution. 

A  different  outlook,  however,  ob- 
tains with  the  young  delinquent  of 
normal  or  slightly  sub-normal  men- 
tality. Often  proper  advice  tactfully 
applied,  coupled  with  a  judicious  fol- 
low-up, will  make  possible  a  change 
for  better  in  her  mode  of  life  and  in 
the  end  restore  her  to  a  firm  social 
footing.  It  is  in  cases  of  this  kind 
that  the  worker  can  produce  the  most 
impressive  results. 


WELFARE  AND  REHABILITATION        153 

The  pre-delinquent  phase  is  by  its 
nature  quiet,  but  most  important 
work.  Young  people  living  in  over- 
crowded rooms  and  amidst  insanitary 
conditions,  or  under  the  domination 
of  criminal  or  cruel  parents,  or  sur- 
rounded by  other  demoralizing  influ- 
ences, are  removed  to  better  planes 
of  life,  thus  saving  them  to  them- 
selves and  to  the  state.  It  may  be 
remarked  that  more  energy  is  being 
directed  toward  this  question  than 
formerly — the  proverbial  ounce  of 
prevention  being  properly  considered 
as  worth  more  than  the  pound  of  cure. 
But  whether  it  is  the  pre-delinquent 
rescued,  the  young  woman  reformed, 
or  the  hardened  character  restrained, 
the  value  of  social  service  to  a 
community,  viewed  from  the  angle  of 
the  individual  case,  more  than  justi- 
fies itself. 


154  VICE  AND  HEALTH 

While,  primarily,  the  social  work- 
er's first  concern  should  be  the  suc- 
cessful handling  of  individual  cases, 
it  is  by  no  means  her  limitation.  In 
fact,  unless  connected  with  a  court  or 
an  organization  in  a  large  city,  where 
the  amount  of  work  naturally  calls 
for  exclusive  specialization,  the  possi- 
bilities will  not  be  reached,  if  she 
stops  there. 

With  the  ever-increasing  and 
natural  interest  of  women's  groups  in 
national,  state  and  local  welfare, 
much  constructive  work  can  be  ac- 
complished through  them.  Armed 
with  convincing  facts  developed  with- 
in her  field,  the  worker  should  be  able 
to  generate  a  decided  interest  for  the 
general  program.  Therefore,  a  well- 
guided  influence  in  this  direction  will 
assist  in  molding  personal  and  official 
opinion  to  the  necessity  of  clinics, 
detentional  facilities,  community  edu- 


WELFARE  AND  REHABILITATION        155 

cation,  recreation,  and  rational  law 
enforcement.  Indeed  the  agent  is 
only  restricted  by  her  own  qualifi- 
cations. Accordingly,  it  becomes  ex- 
tremely important  to  obtain  for  such 
service  an  individual  not  only 
thoroughly  acquainted  with  the  ab- 
stract academic  features,  but  one  who 
is  qualified  as  to  personality. 

Sex  hygiene  demands  a  solid  back- 
ground of  common  sense  to  keep 
the  subject,  from  the  worker's  angle, 
on  an  even  keel.  Over-trained  spe- 
cialists should  therefore  be  studi- 
ously avoided. 

For  a  state  approach,  rehabilitative 
measures  are  fittingly  applied  by  the 
social  service  personnel  connected 
with  the  clinics,  already  touched  upon 
in  a  former  chapter.  In  addition,, 
employment  bureaus  of  both  the  state 
and  municipality  can  be  utilized  in 
restorative  activities.  A  successful 


156  VICE  AND  HEALTH 

plan  has  been  operated  in  Pennsyl- 
vania, which  involves  the  diversion  of 
the  hopeful  cases  freed  from  quaran- 
tine to  the  State  Employment  Agency 
which,  in  turn,  locates  the  person  in 
self-respecting  work,  either  in  a  state 
institution  (by  way  of  demonstra- 
tion) or  other  suitable  place,  the  scar- 
let letter  being  removed  in  the  pro- 
cess. It  is,  however,  emphasized  in 
this  connection  that  only  the  women 
amenable  to  rehabilitative  attempts 
during  the  quarantine  period  should 
be  considered. 

There  is  another  class  (all  too  com- 
mon) which  becomes  a  very  impor- 
tant problem ;  and  its  solution  has  as 
yet  not  received  the  attention  that  it 
deserves.  Reference  is  made  to  those 
young  girls  and  women  who  possess 
a  constitutional  moral  obliquity,  and 
whose  actions  are  based  upon  an  in- 
herent weakness  of  character  rather 


WELFARE  AND  REHABILITATION        157 

than  upon  downright  criminality 
or  viciousness. 

Experiments  made  upon  women  of 
this  kind  indicate  that  rehabilitation 
methods  are  of  little,  if  any  avail; 
they  are  neither  responsive  to  the  con- 
structive help  of  the  social  service 
worker  nor  to  the  punishment  meted 
out  by  the  legal  authorities.  Imprison- 
ment is  apparently  a  periodic  experi- 
ence in  their  lives,  and  while,  of 
course,  smarting  under  the  confine- 
ment, they  are  not  in  the  least  deterred 
by  it.  These  are  the  repeaters — the 
familiar  faces  coming  before  the 
magistrate ;  and  no  end  of  counsel  and 
no  amount  of  punishment  appear  to 
do  them  any  good. 

Under  present  conditions,  medical 
treatment  is  about  all  that  can  be 
given  them.  Once  rendered  non- 
infectious,  they  are  turned  loose  upon 
the  community  and  a  reinfection 


168  VICE  AND 

again  makes  it  possible  for  them  to 
do  great  damage. 

While  industrial  schools  will  very 
greatly  help  a  number  of  such  per- 
sons, the  majority  are  not  susceptible 
to  any  training.  Being  neither  insane 
nor  imbecile  it  is  impossible  to  com- 
mit them  to  psychopathic  institutions. 
Personal  care  and  custody  for  a  long 
period  seems  to  be  the  only  solution; 
and  farm  colonies  with  their  outdoor 
work  and  manual  labor  seem  to  pos- 
sess the  elements  of  humanitarism 
and  rational  therapy  so  necessary 
under  such  circumstances. 

As  a  distinct  remedial  measure,  the 
industrial  home  is  of  great  service. 
Particularly  is  this  so  with  the  youth- 
ful misdemeanant.  An  indeterminate 
sentence  calling  for  confinement  at 
such  a  place,  where  training,  work 
and  moral  uplift  are  all  emphasized, 
will  have  infinitely  more  permanent 


WELFARE  AND  REHABILITATION        169 

effect  upon  her  than  being  lodged 
with  the  demoralizing  company  of 
the  average  jail.  As  a  matter  of 
fact,  iron  bars  alone  have  never  ac- 
complished reform. 

These  questions  likewise  call  for 
the  leadership  to  be  found  in  the  quali- 
fied social  worker.  Suggestions,  while 
in  themselves  necessary,  are  of  little 
moment  unless  carried  out;  and  the 
sustained  interest  looking  to  such  a 
conclusion,  is  properly  and  should  be 
effectively  borne  by  those  in  the  com- 
munity who  are  paid  to  do  just  that 
sort  of  thing. 

The  angles  of  general  social  wel- 
fare work  are  many  and  diverse.  Fac- 
tories, industrial  plants  and  com- 
munity service  organizations,  all  de- 
signed to  increase  the  social  morale, 
indicate  to  some  extent  the  large  pro- 
portions of  this  comparatively  recent 
activity.  It  is  being  realized  more 


ICO  VICE  AND  HEALTH 

and  more  that  factories  filled  with, 
fresh  air  and  sunshine  together  with 
general  sanitary  conditions,  plus 
mental  and  social  therapy,  are  sound 
business  principles.  The  outlook 
from  a  community  welfare  standpoint 
is  exceedingly  favorable. 

Moreover,  organized  recreation  is 
playing  its  part.  The  American  Play- 
ground Association  and  the  Boys  and 
Girls  Scouts  are  engendering  princi- 
ples of  morality  and  body  building 
which  should  have  a  lasting  effect 
upon  American  youth.  As  a  moral 
regulator,  and  hence  as  a  prophylactic 
against  disease,  properly  guided  play 
and  recreation  are  unsurpassed.  A 
social  worker  is  in  a  position  to  suc- 
cessfully advocate  the  gospel  of  fresh 
air  and  rational  outdoor  diversion  for 
all  classes;  and  her  program  is  not 
complete  unless  she  does  so. 


CHAPTER  XI 

GOOD  GOVERNMENT 

The  various  methods  of  attack 
already  mentioned,  while  essential  to 
any  headway  with  the  venereal  prob- 
lem, very  decidedly  need  an  alliance 
with  good  government  for  any  basic 
readjustment. 

The  present  system  of  local  ad- 
ministration, as  applied  in  the  ma- 
jority of  cities,  is  dominated  by  politi- 
cal groups,  which,  concerned  with 
their  own  selfish  interests,  are  prone 
to  be  quite  indifferent  to  rock-bottom 
reconstructive  measures.  Conse- 
quently candidates  are  chosen  for 
office  not  because  of  any  displayed  or 
supposed  aptitude  but  upon  a  basis  of 
expediency.  A  certain  western  com- 
munity, for  example,  recently  elected 
11  MI 


162  VICE  AND  HEALTH 

as  its  chief  executive  a  man  of  limited 
education  and  lacking  in  personal 
business  initiative ;  and  his  associates 
who  were  chosen  at  the  same  time 
were  more  or  less  of  the  same  caliber. 
It  is  not  strange  that  men  of  this  type 
are  controlled  and  the  finer  sensibili- 
ties of  office  thus  throttled.  Police 
departments  as  a  result  do  not  possess 
the  necessary  inspiration,  and  fail  to 
develop  morale ;  and  organized  forces  j 
of  evil  already  established  become  | 
more  or  less  permanently  powerful,  jj 

Rotary,  Kiwanis  Clubs,  Chambers 
of  Commerce,  and  civic  organizations 
undoubtedly  have  great  community 
value,  but  as  the  above  suggests,  pres- 
ent day  municipalities  are  not  ruled 
by  resolutions  from  such  bodies — pro- 
fessional politicians  have  the  last 
word  always. 

The  fault  is  not  with  the  politician 
or  the  form  of  government,  but  with 


GOOD  GOVERNMENT  163 

the  average  citizen  who  prefers  to 
delegate  his  inherent  political  inter- 
ests to  someone  who  has  more  time 
than  he  has  to  "  bother  with  them  ". 
The  inevitable  thus  occurs. 

The  man  looking  for  the  job  and  the 
cash  it  will  bring  him  connects  with 
the  politician — if  he  himself  is  not 
already  one — and  spends  time,  money 
and  energy  to  accomplish  his  desires ; 
while  the  bank  president  and  success- 
ful business  man  are  content  to  gather 
their  coats  about  them,  keep  out  of 
the  mud  and  vote  for  those  of  their 
party  who  are  being  cleverly  manipu- 
lated to  office. 

In  this  connection!  an  eastern  city 
recently  lost  a  police  magistrate  who 
was  slain  in  a  disorderly  house  whose 
patron  he  was.  The  righteous  indig- 
nation of  the  men  and  women  who 
represent  the  commercial  life  of  that 
community  was  consequently  aroused. 


164  VICE  AND  HEALTH 

They  at  last  realized  that  while  the 
very  life  blood  of  their  locality, 
through  its  manufacturing  interests, 
commerce  and  tangible  wealth,  was 
controlled  by  them,  another  group 
who  existed  upon  crime  and  its  pro- 
ceeds, were  dictating  the  conditions 
under  which  they  and  their  chil- 
den  should  live.  And,  further,  that 
these  conditions  developed  a  danger- 
ous atmosphere.] 

Today  the  representative  men  of 
that  locality  are  politically  in  control, 
and  inspired  and  assisted  by  their 
women-folk,  are  officially  directing 
affairs.  With  the  erstwhile  politician 
discredited,  and  people  in  office  whose 
primary  interest  is  service,  crime  and 
disease  among  other  disorders  are  be- 
ing relentlessly  fought. 

While  the  above  illustration  was  an 
aggravated  case  and  the  reaction  ex- 
ceedingly strenuous,  the  general  out- 


GOOD  GOVERNMENT  165 

look  nevertheless  is  bright.  By  perse- 
verance and  elemental  justice,  women 
now  have  their  word  at  the  polls,  and 
in  consequence  they  are  intensely 
interested  in  politics.  Attempts  to 
develop  blind  partisanship  within  the 
feminine  ranks  have  failed.  This  con- 
tingent is  not  especially  interested  in 
local  Eepublican  or  Democratic  can- 
didates, as  such,  but  it  is  anxious  to 
see  men  in  control  who  represent 
ideals,  clean  conditions  and  real  ser- 
vice. Is  the  candidate  personally 
decent?  Does  he  stand  for  a  right- 
eous administration?  Will  he  sin- 
cerely and  conscientiously  protect  the 
community  against  vice  ?  These  ques- 
tions will  have  to  be  answered  satis- 
factorily before  the  women  bestow 
confidence  with  their  ballots. 

In  addition  to  voting  for  candi- 
dates, women  of  organizations,  such 
as  the  League  of  Women  Voters,  The 


166  VICE  AND  HEALTH 

Federated  Clubs,  and  others,  will  suc- 
cessfully persuade  their  husbands, 
hitherto  scorning  politics,  to  become 
personally  interested.  This  will  re- 
sult in  enlisting  them  in  the  fight 
against  corrupt  politics,  even  to  the 
extent  of  their  becoming  candidates 
themselves.  Moreover,  women  will 
soon  be  directly  controlling  the  house- 
keeping phases  of  government  by 
popular  election  to  offices  of  this  nat- 
ure ;  and  it  cannot  come  too  soon. 

Due  credit  must  be  given  to  the  men 
on  their  own  account.  Recent  years 
have  demonstrated  a  weakening  of 
the  old-time  laxity  in  municipal 
matters.  A  very  definite  minority 
have,  under  one  guise  or  another,  sup- 
ported an  aspirant  for  reasons  other 
than  his  political  connection.  Indeed, 
the  non-partisan  feature  of  com- 
mission government  has  given  great 
strength  to  this  attitude  even  though, 


GOOD  GOVERNMENT  167 

by  reason  of  machine  tactics,  its  full- 
est expression  is  as  yet  unrealized. 

It  is  but  logical  to  suppose  that 
thoughtful  and  progressive  men  and 
women  will  in  the  near  future  under- 
stand that  community  welfare  is  a 
much  larger  problem  than  punish- 
ment and  prison;  and  that  from  the 
standpoint  of  venereal  diseases,  the 
immoral  can  no  longer  be  left  to 
churches  and  courts  to  reform,  the  vi- 
cious to  the  penitentiaries  to  punish, 
and  the  feeble-minded  to  roam  at 
large.  It  will  also  be  appreciated, 
that  housing  problems  are  by  no 
means  limited  to  cries  against  the 
tenement  house  profiteer,  and  that  the 
general  uplift  of  a  city  cannot  solely 
rely  upon  the  occasional  expression  of 
some  rich  man's  philanthropy. 

Prophylaxis  in  its  most  compre- 
hensive sense  will  then  be  considered 
a  vital  necessity.  Community  houses, 


168  VICE  AND  HEALTH 

recreation  centers,  rational  amuse- 
ments and  municipal  welfare  will 
receive  the  attention  they  deserve. 
Stress  will  be  placed  upon  the  pre- 
vention of  crime,  more  time  and 
energy  will  be  expended  upon  the  con- 
ditions that  foster  disease,  and  hous- 
ing conditions  will  be  approached 
from  other  than  the  ledger  point  of 
view.  All  of  this  is  reasonable,  and 
the  more  so  because  it  will  pay. 
Eliminating  sentiment,  the  Golden 
Rule  is  the  soundest  kind  of  a  busi- 
ness principle ;  crime,  disease  and  its 
associate,  corrupt  politics,  cost  enor- 
mously in  dollars  and  cents  alone. 
This  cold-blooded  business  argument 
is  being  realized  more  and  more ;  and 
the  sentimental  one  (if  compassion 
and  pity  for  suffering  and  disease  can 
be  so  styled)  is  becoming  most  vigor- 
ously the  concern  of  women. 

To  conclude:  If  citizens  will  look 


GOOD  GOVERNMENT  169 

upon  their  town  as  a  corporation  in 
which,  they  have  a  special  personal 
interest,  and  elect  worthy  representa- 
tives on  the  planks  of  righteousness, 
efficiency  and  economy,  the  elimina- 
tion of  vice  and  its  attendant  evils  will 
speedily  ensue. 


INDEX 

Almsihouses,  use  of,  as  place  of  quarantine,  131 
Apartmemt  Houses,  regulation  of,  113 
Army,  physical  condition  of,  45 
Automobiles,  adjuncts  to  vice,  16,  31,  33 

Cabarets,  assignment  possibilities  in,  118 

"  Call "  resorts,  definition  of,  30 

Camps,  eradication  of  disease  in,  71 

Case  work,  in  clinics,  151 

Central  quarantine  hospital,  advantages  of,  132 

Chamberlain-Kahn  fund,  purpose  of,  78 

Chauffeurs),  connection  with  vice,   116 

Clandestine  vice,  definition  of,  110 

Clinics,  establishment  of,  73 

"Closed"  dance  halls,  definition  of,  117 

Commission  on  training  camps,  67 

County  jails,  use  of  as  place  of  detention,  131 

Dance  halls,  control  of,  118 
Dance  halls,  evils  of,  15 
Delinquency,  how  handled,  152 
Detention  hospitals,  necessity  of,  131 

Education,  advantages  of,  137 
Everhart,  Dr.,  remarks  of,  52 

Fines,  inefficiency  of,  102 

171 


172  INDEX 

Free  clinics,  how  financed,  83 

Gans,  Dr.  S.  L.,  statement  of,  52 
Government's  fight,  statistics  on,  81 
Group  education,  how  accomplished,  143 

Hardened  prostitutes,  disposition  of,  152 

Health  menaces,  defined,    126 

Hospitals,  clinics  in,   84 

Hotels,  attack  in,  112 

Hotels,  government's  attack  upon,  70 

Hotels,  use,  of,  for  immorality,  28,  41 

Houses  of  prostitution,  internal  economy  of,  37 

Industrial   homes,   advantages   of,    158 
Interdepartmental  Board,  creation  of,  77 

Jails,  use  of,  as  place  of  detention,  131 

Law  enforcement,  limitations  of,  119 

Law  enforcement  representative,  duties  of,   105 

Liquor,  use  of,  in  houses  of  prostitution,  36 

Martin,  Dr.  E.,  statement  of,  49 
Mayor,  power  of,  104 
Medical  regulation,  failure  of,  24 
Mexican  border,  activities  on,  64 
Motion  pictures,  publicity  use  of,   144 

Normal  schools,  education  in,  141 

Pamphlets,  educational  use;  of,  146 
Panderers,   definition  of,   115 


INDEX  173 

Pennsylvania,  quarantine  in,  134 

Pennsylvania  State  Police,  duties  of,  as  health 
officers,  135 

Pershing,  General,  remarks  of,  27 

Pierce,  Assistant  Surgeon  General,  remarks  of,  30 

Play,  a  moral  regulator,  160 

Policemen,   attitude  toward   prostitution,    101 

Potter,  Dr.  E.  C.,  statement  of,  51 

Pre-delinquency,  how  handled,  153 

Pre-natal  clinics,  necessity  of,  90 

Prison  sentence,  advantages  of,  103 

Prison,   sentence,   handicaps  of,    123 

Prisons,  objections  to  use  of,  as  places  of  quaran- 
tine*, 132 

Prisons,  use  of,  as  place  of  quarantine,  131 

Procurers,  methods  of,  38 

Prophylaxis,  arguments  for  and  against,  93 

Prostitution,   causes  of,    12 

Prostitution,  definition  of,  11 

Prostitution,  statistics  on,  48 

Publicity,  advantages  of,  145 

Quacks,  disposition  of,  87 
Quarantine,  advantages  of,  134 
Quarantine!,  methods  of  applying,  130 
Quarantine,  military,  69 

Raids,   discrimination   in  favor  of  casual,   127 
Reform,  attempts  at,  19 
Rehabilitation,  in  clinics,  155 
Reporting  venereal  cases,  necessity  of,  92 


174  INDEX 

Rooming   houses,   how  regulated,   114 

Rooming  houses,  immoral,  30 

Rural    sanitation,    how    accomplished,    86 

Seattle,  violence,  attempted  in,  23 

Segregation  districts,  attacks  against,   120 

Segregation,  failure  of,  22 

Social   service,  advantages  of,   133> 

Social  work,  development  of,  148 

Social  work,  need  of,  149 

Social    workers,    clinical    activities,    89 

Social  workers,  necessity  of,  85 

State  Police,  use  of,  as  investigators,   107 

Street   solicitation,    definition  of,    31 

Taxicabs,  control  of,   116 
Taxicabs,  ordinances  regulating,  70 
The    American    Playground    Association,    activities 
of,  160 

Vicei,  forms  of,  20 

Vice  Inspector,  duties  and  necessity  of,  106 

White  Slave  Act,  explanation  of,  62 
Women,  political  activities  of,  165 


- 


.     72 
31173810)476^1.32 


General  Library 

University  of  California 

Berkeley 


Yb  07009 


